Test Bank for Burns & Groves The Practice of Nursing Research 8th Edition by Burns, Grove & Sutherla

TEST BANK

TEST BANK

Burns and Grove's The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence 8th Edition Test Bank Chapter 1. Discovering the World of Nursing Research MULTIPLE CHOICE

1. Which best describes evidence-based-practice (EBP)? a.A combination of best research evidence, clinical expertise, and the needs and values of patients. b.A determination of the factor s necessary to control patient responses t o care. c.The development of population care guidelines applicable to all patients. d.The utilization of quantitative and qualitative studies to enhance patient outcomes.

ANS: A Feedback AEvidence-based practice evolve s from the integration of the best research evidence with clinical expertise and patient needs and values.

BStudies that attempt to find determinants of patient outcome s are generally experimental or quasiexperimental. They may be used to guide EBP but do not completely define it.

CEBP is a combination of guidelines and specific patient needs and values.

DQuantitative and qualitative studies applied to the e valuation of patient outcomes are part of EBP but do not completely define EBP. PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 3

2. The nurse is collecting data about the sleep patterns of breastfed babies as par t of a larger research study. Which research method will the nurse use when collecting data for this study? a.Control b.De scription c.Explanation d.Prediction ANS: B Feedback AControl can be described as the ability to write a prescription to produce the desired outcome.

B Description involves identifying and underst anding the nature of nur sing phenomena and the relationships among these phenomena.

C Explanation clarifies the relationships among phenomena and identifies why certain events occur.

D Through prediction, the probability of a specific outcome can be estimated in a given situation. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 6

3. The nurse is participating in a study and is collecting data identifying the number of obese adults whose parents were also obese or overweight. Which research method is being used in thisstudy? a.Control b.De scription c.Explanation d.Prediction ANS: D Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BDescription involves identifying and under standing the nature of nur sing phenomena and the relationships among these phenomena.

CExplanation clarifies the relationships among phenomena and identifies why certain events occur.

DThrough prediction the probability of a specific outcome can be estimated in a given situation. By knowing the percentage of parents of obese adult s who were obese, the probability of predicting this may be calculated.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 78

4. The nurse reviews a study in which adherence to an asthm a action plan is compared among groups of adolescents who received different asthma education. Which research method does thisrepresent? a.Control b.De scription c.Explanation

d. Prediction ANS: C Feedback A Control indicates the ability to use a prescribed intervention to produce a desired outcome.

B Description involves identifying and underst anding the nature of nur sing phenomena and the relationships among these phenomena.

C Explanation clarifies the relationships among phenomena and identifies why certain eventsoccur.

D Through prediction, the probability of a specific outcome can be estim ated in a given situation.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 7

5. A nurse manager is interested in learning which attitudes am ong staff nur ses may indicate relative risk of needle-stick injuries. To study this, the nurse manager will employ which method of study? a.Control b.De scription c.Explanation d.Prediction ANS: D Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BExplanation clarifies the relationships among phenomena and identifies why certain events occur.

CDescription involve s identifying and understanding the nature of nur sing phenomena and the relationships among these phenomena.

DThrough prediction, the probability of a specific outcome can be estim ated in a given situation.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 7-8

6. Which is the most import ant result of Florence Nightingales dat a collection and st atistical analysis during the Crimean War?

a.Bringing awareness of the rigors of war to the general public. b.Developing a process for st atistical analysis and nursing documentation. c.Identifying and defining the role of nurses in modern health care. d.Using clinical research to evaluate the importance of sanit ation, clean drinking water, and adequate nutrition.

ANS: D Feedback AThis was not the most import ant result BThis was not the m ost important result CThis was not the most important result DNightingales rese arch enabled her to instigate attitudinal, organizational, and social changes, including the militarys approach to the care of the sick and societys sense of responsibility for testing public water, improving sanitation, and preventing starvation to decrease morbidity and mortality rates.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 11

7. The nurse participates in dat a collection in a study in which two different pain m anagement prot ocols are used with randomly assigned patients to me asure differences in postoper ative recovery time. Which method of study is this? a.Control b.Correlation c.Description d.Explanation ANS: A Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BCorrelation examines the relationships between different phenomena.

CDescription involve s identifying and understanding the nature of nur sing phenomena and the relationships among these phenomena.

DExplanation clarifies the relationships among phenomena and identifies why certain events occur.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 8

8. The development of nursing theories and conceptual models in the late 1960s and 1970s served to: a.determine the effectiveness of nursing interventions. b.est ablish the concept of evidence-based practice. c.provide funding for nursing research. d.provide direction for nursing research.

ANS: D Feedback AOutcome studies are used to determine the effectiveness of nursing interventions.

BThe concept of EBP was de veloped in the 1970s and pr omoted by the ANCC Magnet Designation program.

CThe NINR seeks to provide funding for nursing research.

DThe theories developed in the 1960s and 1970s helped to direct future nursing rese arch. PTS: 1 DI F: Cognitive level: Understanding (Comprehension) REF: pp. 11-12

9. Under Ada Sue Hinshaw, the National Institute of Nursing Research (NINR) began to change its focus to: a.funding nur sing r ather than medical research. b.evaluating outcomes r ather than pr ocess studies. c.increasing the status and funding for nursing research. d.supporting the dissemination of nursing research.

ANS: C Feedback AThe change in focus from medical to nursing research came about with the first nursing programs.

Specialty nursing organizations today and some nursing researchers still conduct medical research for specific studies.

BOutcomes rese arch emerged in the 1980s and 1990s t o document the effectiveness of he alth care services.

CUnder Ada Sue Hinshaw, the national Center for Nursing Research (NCNR) changed its name to the NINR to increase the status and funding of nursing research.

DThe NCNRs purpose was to support the dissemination of nursing research. PTS: 1 DIF: Cognitive level: Remembering (Knowledge)

REF: pp. 12-13

10. An emphasis of the American Nurse s Credentialing Center (ANCC) Magnet Hospital Designation Program for Excellence in Nursing is: a.research and de velopment of clinical practice guidelines. b.putting qualitative research into practice in clinical settings. c.using standard nursing care plans based on outcomes rese arch. d.utilizing evidencebased practice in nursing.

ANS: D Feedback AClinical pr actice guidelines are a more recent phenomenon, using evidence -based research, expert opinion, and patient needs and values to standardize care.

BQualitative research was introduced in the late 1970s to gain insight into the phenomena relatedto nursing.

COutcomes research was important in the 1980s to 1990s to document the effectiveness of he alth care services.

DANCC implemented the Magnet Hospit al De signation Program for Excellence in Nur sing Service in 1990 that emphasized EBP for nursing.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 1213

11. In a position statement in 2006, the American Association of College s of Nursing (AACN) identified a need to: a.acquire clinical knowledge and expertise. b.focus on evidence-based practice. c.fund academic nursing research. d.prepare a workforce of nurse scientists.

ANS: D Feedback ABasic nursing education focuses on clinical knowledge and expertise.

BEvidence-base d practice is a focus of ANCC and the Magnet Designation Pr ogram for Excellence in Nursing Service.

CThe NINR focuses on funding for nursing research.

DThe AACN identified the importance of creating a research culture, providing high -quality educational program s to prepare a workforce of nur se scientists, develop a sound research structure, and obt ain funding for nursing research.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 14

12. The lead agency designated to improve health care quality is: a.Agency for Healthcare Research and Quality (AHRQ). b.American Nurse s Credentialing Center (ANCC). c.Quality and Safety Education for Nurse s (QSEN). d.National Institute for Nursing Research (NINR).

ANS: A Feedback AAHRQ is a scientific partner with the public and private sectors to improve the quality and safety of patient care.

BANCC provides credentialing for advanced practice nurse s and for Magnet Designation for Excellence in Nursing Service CQSEN is focuse d on developing the requisite skills, knowledge, and attitude st atements for the competencies for prelicensure and graduate education.

DThe National Institute of Nursing Rese arch, originally the National Center for Nur sing Re search, is a federally funded arm of the National Institutes of Health, providing nursing with federal support for nursing research priorities.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 1213

13. To help fulfill the mission of the National Institute for Nur sing Re searchto promote and improve the health of individuals, families, communities, and populationsa study may be conducted which: a.assesses the effectiveness of strategies for weight m anagement in patients with type 2 di abetes. b.compare s the attitudes of nurses toward clients with type 1 and type 2 diabetes. c.generates up-t o-date nursing diagnose s reflecting the needs of clients with type 2 diabetes. d.reviews hospital nurses adherence to glucose-monitoring guidelines for patients with type 2 diabetes.

ANS: A Feedback AA study that assesses the e ffectivene ss of interventions helps to improve the health of patient populations by identifying appropriate strategies.

BA comparison of attitudes is a descriptive study that does not improve outcomes.

CA study to generate nursing diagnoses does not directly affect patient outcomes.

DA study reviewing adherence to guidelines seeks t o provide data for quality assurance.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 14-15

14. Which best describe s the Quality and S afety Education for Nurse s (QSEN) competency for evidencebased practice (EBP)? a.Adhering to published guidelines to provide care for a specific population. b.Empowering clients to choose among effective dise ase management strategies. c.Relying on expert knowledge to guide care plan development for an individual patient. d.Using evidence gained solely from experimental studies to guide care.

ANS: B Feedback AStrict adherence to guidelines does not take the patient/family preferences into account.

BThe QSEN competency for EBP is define d as integrating the best evidence with clinical expertise and patient/family preferences.

CEBP does not rely solely on expert knowledge or experimental studies.

DAlthough experimental studie s pr ovide the highe st level of study data, EBP does not rely soley on experiemental studies..

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 15

15. Through knowle dge gained from her phe nomenological qualitative study identifying levels of experience of professional nurses, Patricia Benner would identify which nurse as an expert? a.A hospice nurse who values the unique wishes of each patient when providing palliative care. b.A medical-surgical nurse who organize s care for a group of patients to ensure timely administration of medications. c.A neonatal intensive care nurse who is skilled in inserting peripherally inserted centralcatheters. d.A pediatric nurse who notes subtle changes and intervenes to prevent respiratory failure.

ANS: D Feedback AThe proficient nurse views the patient as a whole and recognize s that each patient responds differently to illness and health.

BThe competent nurse is able to achieve goals and plans and to t ake conscious actions to organize and provide efficient care.

CThe NIC nurse is also an example of a competent nurse who is skilled in a procedure.

DThe expert nurse has an extensive background of experience and is able to identify and accurately intervene skillfully in a situation. The pediatric nurse in this case recognizes subtle changes and is able to act

to prevent serious circumstances.

Chapter 2. Evolution of Research in Building Evidence-Based Nursing Practice MULTIPLE CHOICE

1. In which way did Florence Nightingale contribute to evidence-based practice? a. She conducted research on outcomes and the power of nursing for change. b. She was the first woman elected to the Royal Statistical Society. c. She gathered data that changed the care of hospitalized soldiers. d. She calculated mortality rates under varying conditions.

ANS: C Nightingale gathered dat a on soldier morbidity and m ortality rates and the factors influencing them and presented her results in tables and pie charts, a sophisticated type of dat a presentation for the period.

Nightingales research enabled her to instigate attitudinal, organizational, and social changes. She changed the attitudes of the military and society toward the care of the sick. The milit ary began to view the sick as having the right to adequate food, suitable quarters, and appropriate medical treatment, which greatly reduced the mortality rate.

DIF: Cognitive Level: Application REF: MCS: 17

2. If a nurse manager want s to study how well last years policies governing implementation of a bundle of interventions to prevent cross-contamination of MRSA have been wor king in her units, which of the following strategies would she use?

a. Outcomes research b. Intervention research c. Ethnographic research d. Experimental research ANS: A Outcomes research emerged as an important methodology for documenting t he effectivene ss of he alth care services in the 1980s and 1990s. This type of rese arch evolved from the quality asse ssment and quality assurance functions that originated with the professional standards review organizations (PSROs) in 1972.

During the 1980s, William Roper, the director of the He alth Care Finance Administration (HCFA), prom oted outcomes research for determining the quality and cost-e ffectivene ss of patient care. Intervention research investigate s the effectivene ss of a nursing intervention in achieving the desired outcome or outcomes in a natural setting. Through the use of ethnogr aphic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on human behavior and health. Experi mental

studies have three main characteristics: (1) a controlled m anipulation of at least one treatment variable (independent variable), (2) administration of the treatment to some of the subjects in the study (experimental group) and not to others (control group), and (3) r andom selection of subjects or random assignment of subjects t o groups, or both. Experimental studies usually are conducted in highly controlled settings, such as laboratories or research units in clinical agencies.

DIF: Cognitive Level: Analysis REF: MCS: 22

3. A researcher publishe s a paper de scribing how faith, pain, adherence to therapy, and medit ation interact during the rehabilit ation process. The description of the pr ocess is based on m any interviews the rese archer conducted with persons during and following rehabilitation experiences. The methodology is

a. Ethnography b. Phenomenology c. Historical research d. Grounded theory ANS: D Grounded theory methodology emphasizes observation and the development of practice -based intuitive relationshi ps am ong variables. Throughout the study, the researcher formulates, tests, and redevelops propositions until a the ory evolves. The theory de velope d is grounded, or has its roots in, the data from which it was derived.

DIF: Cognitive Level: Synthesis REF: MCS: 27

4. A panel of rese archers conduct s several studie s, all drawn from an existent hospit al and clinic database.

The studies focus on quality and effectiveness within that system. The specific studies address mortality r ates in elders within a ye ar after hip fracture, functional outcome s six months after admission to a neur osurgical ICU after traum atic brain injury, rate of nur se injuries in an emergency de partment, and number of patient falls on various floors of the hospital. What type of research is this?

a. Experimental research b. Outcomes research c. Ethnographic research d. Grounded theory research ANS: B The spiraling cost of health care has generated many questions about the quality and effectiveness of health care services and the patient outcome s. Consumers want t o know what services they are buying, and whether these services will improve their health. He alth care policy makers want to know whether the care is costeffective and of high quality. The se concerns have prom oted the de velopment of outcomes rese arch, which

examines the results of care and measure s the changes in health status of patients. It can also examine costs related to care delivery within a hospital system.

DIF: Cognitive Level: Comprehension REF: MCS: 27

5. A researcher designs a study. It depends on que stionnaires for data, it has a clear purpose st atement, it provide s its results as a narrative without statistical analysis, and it makes general suggestions for practice.

What type of research is this?

a. Qualitative research b. Outcomes research c. Intervention research d. Quantitative research ANS: D Quantitative rese arch is a formal, objective, systematic process in which numerical dat a are used t o obt ain information about the world. Qualitative rese arch is also systematic, but it is a holistic, interactive , and subjective approach to de scribe life experiences and identify their meaning. Both types of research have a purpose statement and can use a survey instrument; however, neither depends on surveys for data. Both can contain sugge stions for practice. Qualitative research result s are pre sented as a narrative , without statistical analysis. Outcomes research examine s the results of care and me asure s the change s in health status of patients. Intervention research investigate s the effectivene ss of a nursing intervention in achieving the desired outcome or outcomes in a natural setting.

DIF: Cognitive Level: Application REF: MCS: 23

6. A newly employed nurse administrator wants t o know m ore about the employees on the units the administrat or supervise s. The manager acce sses the managerial dat abase and gathers data about all of the current employees on the unit, including work shift , number of years employed, age, gender, educational preparation, certifications, work history, and professional accomplishments. What type of research is this?

a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: A The quantitative rese arch methods are classified into four categories: (1) descriptive , which de fines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variable s, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random

assignment. This is a research study, even though it depends upon existent data, collected by another manager. Its purpose is to describe the employees.

DIF: Cognitive Level: Analysis REF: MCS: 26

7. A human resources employee per forms research focusing on the pr ofessional lifespan within the institution of nur ses, and trying to discover whether their choice of wor k area is connected with the number of years they work in the institution. What type of research is this?

a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: B The quantitative rese arch methods are classified into four categories: (1) descriptive , which de fines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variable s, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This study investigates the connection or association between wor k area and length of time worked.

DIF: Cognitive Level: Analysis REF: MCS: 26

8. In an attempt to asse ss whether selection of a same-gender psychiatrist le ads to better mental he alth outcomes, clients newly referred for ment al health services are told they m ay choose their mental he alth physicians. Later, measures of mental health are performed. What type of researchis this?

a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: C The quantitative rese arch methods are classified into four categories: (1) descriptive , which de fines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variable s, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This research study is designed to test an intervention but does not include random assignment.

DIF: Cognitive Level: Analysis REF: MCS: 26

9. In a rehabilitation unit, patient s are randomly assigned to high fiber diets versus ordinary fiber diets, in order to measure the effect on constipation. What type of research is this?

a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: D The quantitative rese arch methods are classified into four categories: (1 ) descriptive , which de fines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variables, (3) quasi-experimental, which tests an intervention and lacks either a control group or random assignment, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This research study tests an intervention and include s both a control group and random assignment.

DIF: Cognitive Level: Analysis REF: MCS: 26

10. A researcher uses interviews with two or three open-ended que stions to study women in the staging phase of breast cancer treatment, in order to underst and their experiences and the meanings they attribute to those experiences. What type of research is this?

a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: A Phenomenologic research examines the lived experiences of participants and the meanings those experiences hold for them, dr awing it s results only from the participants views. Grounded theory rese arch de fines underresearched concept s and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concepts, and sometimes generating theory; it emphasizes interaction, observation, and de velopment of relationships among concept s. Ethnography define s shared char acteristics of member s of a culture or participants who share in a common char acteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our underst anding of the impact of culture on the human experience. Historicism tells the story of past events, reconstructing these fr om other hist orical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27

11. A researcher uses interviews with eight open-ended questions to study women in a new staging phase of breast cancer treatment, which includes serial biopsies and necessitates weekly closed biopsy, in order to underst and m ore about social factors that impinge upon their experience. What type of research is this?

a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: B Grounded theory rese arch de fines under-rese arched concept s and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concept s, and sometimes generating theory; it emphasizes interaction, observation, and de velopment of relationships among concepts. Phenomenologic research examines the lived experiences of participant s and the meanings those experiences hold for them, drawing its results only fr om the participant s views. Ethnography de fines shared char acteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic rese arch, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on the human experience.

Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27

12. A researcher conduct s many interviews, over a one-ye ar period, with women in the treatment phase of breast cancer, all of whom are attending a bre ast cancer support group, in order to understand what happe ns in the support group, how the members are affected by membership, and how the member s contribute to the group. The researcher herself is also in treatment for breast cancer and is a member of the group. What type of research is this?

a. Phenomenologic research b. Grounded theory research c. Ethnographic research

d. Historicism ANS: C Ethnography define s shared characteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural fr amework, using observation, interview, and other data collection strategie s; through the use of ethnographic rese arch, different cultures are described, compared, and contrasted to add to our underst anding of the impact of culture on the human experience. Phenomenologic research examines the lived experiences of participant s and the meanings those experiences hold for them, drawing its result s only fr om the participant s views. Grounded t heory research defines under-rese arched concepts and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the conce pts, and sometimes generating theory; it emphasizes interaction, observation, and development of relationships among concepts.

Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27

13. A researcher reviews the twenty years that a breast cancer clinic has been in oper ation in a sm all Midwestern city. The researcher interviews m any of the women who have been treated in the clinic during this period and reviews the records of the clinic, along with its survival rates and the emergence of several of its innovative support progr ams for women and their families. The rese archer ultimately writes a story of the clinic over those twenty years. What type of research is this?

a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: D

Phenomenologic re search examine s the lived experiences of participants and the meanings those experiences hold for them, drawing its results only from the participants views. Gr ounde d theory research de fines underresearched concept s and explains them within a social framewor k, building on both observation and the perceptions of the persons who are familiar with the concept s, and sometimes generating the ory; it emphasizes interaction, observation, and development of relationships among concepts. Ethnogr aphy define s shared characteristics of members of a culture or participant s who share in a common char acteristic, and explains commonalities, often within a cultural framewor k, using observation, interview, and other data collection strategies; through the use of ethnogr aphic re search, different cultures are describe d, compared, and contrasted to add to our underst anding of the im pact of culture on the hum an experience. Historicism tells the story of past events, reconstructing these from other hist orical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27 MULTIPLE RESPONSE

1. Florence Nightingale rese arched mortality and morbidity rates in soldiers during the Crimean War and investigated various factor s that influenced both, presenting her result s as pie charts and graphs.

Consequently, it is known that she conducted which types of research? (Select all that apply.)

a. Phenomenologic research b. Causational research c. Descriptive research d. Correlational research e. Ethnographic research ANS: C, D Nightingale is noted for her dat a collection and st atistical analyse s during the Crimean War. She gathered data on soldier morbidity and mortality rates and the factor s influencing them and presented her results in tables and pie charts, a sophisticated type of data presentation for the

period. There is no evidence that she designed causational (experimental or quasi-experimental) research or any type of qualitative research.

DIF: Cognitive Level: Analysis REF: MCS: 17

2. Which of the following statements about quantitative research is accurate? (Select all that apply.) a. The results of quantitative research should be generalized back to the population from which the sample was drawn.

b. Quantitative research is always easy and straightforward to read and understand. c. Quantitative research addresses quantities, connections, and causes. d. Quantitative research predominates in the nursing research literature. e. Quantitative research is always experimental. f. Quantitative research provides answers to What? and Who? questions.

ANS: A, C, D, F The quantitative approach to scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axiom s, and predictions. Quantitative rese arch requires the use of structured interviews, questionnaires, or observations, scale s, or physiological measure s that generate numerical data. Statistical analyses are conducted to reduce and organize data, de scribe variables, examine relationships, and determine differences am ong groups. Control, instruments, and statistical analyse s are used to ensure that the research findings accurately reflect reality so that the study findings can be generalized.

Generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sam ple was drawn. Researchers must be cautious in making generalizations, because a sound ge neralization requires the support of m any studie s with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 24

3. Which of the following statements about qualitative research is accurate? (Select all thatapply.) a. Qualitative research deals exclusively with humans. b. Qualitative researchs principal purpose is to inform the reader. c. Qualitative research yields data that are not numbers-based, such as audiotapes, videotapes, and field notes.

d. Qualitative research is not systematic. e. Qualitative research does not contain or imply a research question. f. Qualitative research is ill-defined and vague. g. Qualitative research has no practical use.

ANS: B, C Qualitative rese archers use observations, interviews, and focus gr oups to gather data. The interactions are guided but not controlled in the way that quantitative data collection is controlled. For example, the researcher may ask subjects to share their experiences of powerlessne ss in the he alth care system. Qualitative researchers would begin interpreting the subjective data during data collection, recognizing that their interpretation is influenced by their own perceptions and beliefs. Qualit ative data take the form of words and are analyzed according to the qualitative approach that is being use d. The intent of the analysis is to organize the data into a meaningful, individualized interpretation, framewor k, or theory that describe s the phenomenon studied. The findings from a qualitative study are unique to that study, and it is not the researchers intent to generalize the findings to a larger population. Qualitative researchers are encour aged to question generalizations and to interpret meaning based on individual study participant s perceptions and realities.

DIF: Cognitive Level: Analysis REF: MCS: 25

4. Which is true of quantitative research? (Select all that apply.) a. It addresses human responses by measuring or counting them. b. It presents information by clustering it or counting it. c. It yields a data set that can be analyzed by statistics. d. It operates systematically. e. It states or implies a research question. f. It operates in a concrete realm. g. It can always be generalized.

ANS: A, B, C, D, E, F The quantitative approach to scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axiom s, and predictions. Quantitative rese arch requires the use of structured interviews, questionnaires, or observations, scale s, or physiological measure s that generate numerical data. Statistical analyses are conducted to reduce and organize data, de scribe variables, examine relationships, and determine differences am ong groups. Control, instruments, and statistical analyse s are used to ensure that the research findings accurately reflect reality so that the study findings can be generalized.

Generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sam ple was drawn. Researchers must be cautious in making generalizations, because a sound ge neralization requires the support of m any studie s with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 24

5. Ethnographic research might focus upon which of the following topics? (Select all that apply.)

a. Bacterial cultures b. Cultural beliefs of the ancient Romans c. How children in Alaska play during the winter d. Twenty-year abstinence members of Alcoholics Anonymous e. The mentoring process in a labor-delivery unit f. Conversational Spanish ANS: C, D, E Ethnographic research was developed by anthr opologists to investigate cultures through an in- depth study of the members of the culture. The culture may be an actual culture, a loosely connected group of pe ople who share a common characteristic, or a work or recreational group. The ethnogr aphic rese arch proce ss is the systematic collection, description, and analysis of data to develop a de scription of cultural behavior. The researcher (ethnogr apher) actually live s in or becomes a part of the cultural setting to gather the data.

DIF: Cognitive Level: Analysis REF: MCS: 24

6. A researcher is operating from the point of view of logical positivism . Which of the following rese arch methods would the logical positivist use? (Select all that apply.)

a. Grounded theory research b. Correlational research c. Historical research d. Quasi-experimental research e. Quantitative descriptive research f. Exploratory descriptive qualitative research ANS: B, D, E The quantit ative approach t o scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axiom s, and predictions. The quantitative research methods are classified into four categories: (1) descriptive, (2) correlational, (3) quasiexperimental, and (4) experimental. The qualitative rese arch methods include d in this textbook are (1) phenomenological research, (2) grounded theory rese arch, (3) ethnographic rese arch, (4) explorat orydescriptive qualitative research, and (5) historical research.

DIF: Cognitive Level: Analysis REF: MCS: 27

7. Which of the follow potential studies would fall within the Agency for Healthcare Research and Qualitys future research goals? (Select all that apply.)

a. Performing a synthe sis of research evidence regarding skin-t o-skin cont act of m others and newborns

b. Enacting a quantitative research project measuring bacterial count on nurse s uniform s at the beginning and the end of 12-hour work shifts

c. Performing a qualitative research project to explain sources of student nurses stress d. Enacting a public e ducation Internet commercial encouraging sm okers t o read the statistics regarding sequelae of cigarette smoking

e. Trialing clean-and-sober support groups that are based in community shopping centers ANS: A, D, E The Agency for Healthcare Rese arch and Quality partners with public and private sector s to improve the quality and safety of patient care by promoting the use of the best research evidence available in practice. Its three future goals are focuse d on the following: Safety and quality: Reduce the risk of harm by promoting delivery of the be st possible health care; Effectiveness: Improve healthcare outcome s by encouraging the use of evidence to m ake informed healthcare decisions; and Efficiency: Transform rese arch into practice to facilitate wider access to effective healthcare services and reduce unnecessary costs.

DIF: Cognitive Level: Analysis REF: MCS: 22

8. Early nursing re search by Nightingale focused on improving patient outcome s. What were the principal topics for the next wave of nursing research, in the first half of the 20th century? (Select all that apply.)

a. Evidence-based practice b. Primary nursings advantages in hospitals c. Nursing education, as opposed to nurse training d. The nursing process and nursing diagnosis e. Staffing, patient assignments, and type of care ANS: C, E From 1900 to 1950, rese arch activities in nursing were limited, but a few studies advance d nursing education.

Based on recommendations of the Goldm ark Report, more schools of nursing were established in univer sity settings. A research trend that started in the 1940s and continued in the 1950s focused on the organization and delivery of nursing services. Studies were

conducted on the numbers and kinds of nursing personnel, st affing patterns, patient classification systems, patient and nur se satisfaction, and unit arrangement. Types of care such as com prehensive care, home care, and pr ogressive patient care were evaluated. In the 1970s, the nursing proce ss became the focus of m any studies, with the investigations of assessment techniques, nursing diagnose s classification, goal -setting methods, and specific nursing interventions. Primary nur sing care, which involve s the delivery of patient care predominantly by registered nurses (RNs), was the trend for the 1970s. The vision for nursing research in the twenty-first century include s conducting quality studies using a variety of methodologie s, synthe sizing the study findings into the best research e vidence, and using this research evidence to guide practice. The focus on EBP has become stronger over the last decade.

DIF: Cognitive Level: Synthesis REF: MCS: 19

9. Which of the following is true of the Cochrane Center and Cochrane Collaboration, begun in the 1970s by Professor Archie Cochrane? (Select all that apply.)

a. It was originally called the Walter Reed Army Institute of Research. b. It developed the original masters degrees in nursing practice. c. It serves as a repository for evidence-based practice guidelines. d. It was the first association to publish a nursing research journal. e. It is the online library resource for research literature reviews.

ANS: C, E Cochrane advocated the provision of health care based on research to improve the quality of care and patient outcomes. To facilit ate the use of research evidence in practice, the Cochr ane Center was e stablished in 1992 and the Cochr ane Collaboration in 1993. The Cochr ane Collabor ation and Library house numerous resources to promote EBP, such as systematic reviews of research and evidence-based guidelines for practice.

DIF: Cognitive Level: Evaluation REF: MCS: 20

10. How does quantitative research contribute to evidence-based practice? (Select all that apply.) a. It provides facts that nurse s can add t o their knowledge base. This makes practice more objective and quantifiable.

b. It provides scientific support for policies already in place. More evidence makes an existent policy more defensible.

c. It provides evidence opposing policie s already in place. Evidence in opposition to policies m ay result in new policies.

d. It allows the nur se to understand the personal experience of illne ss and the meaning the client attaches to it. This engenders compassion.

e. It contributes evidence that will make nursing pr actice almost completely evidencebased, eliminating different styles of nursing practice.

ANS: B, C Quantitative rese arch is a formal, objective , systematic process in which numerical data are use d to obtain information about the world. This research method is use d to de scribe variable s, examine relationships am ong variables, and determine cause-and-effect interactions between variables. The qualitative research method of phenomenology allows under standing of the lived experience and the meaning it engenders. The aim of phenomenology is t o explore an experience as it is lived by the study participants and interpreted by the researcher. Evidence-based practice is the conscientious integration of best rese arch evidence with clinical expertise and patient value s and needs in the delivery of quality, cost-effective health care. It provides the basis for policy decisions and for volunt ary change in individual nur sing pr actice. Nursing style is a m atter of personal choice.

DIF: Cognitive Level: Analysis REF: MCS: 23

11. What does appropriate generalization require? (Select all that apply.) a. Any type of sample, whether or not it is representative b. Application of findings to the population from which the sample was drawn c. More than one research study using the same research questions and variables d. Statistically significant findings e. Non-significant findings that are supported by several related studie s ANS: B, C, D

Generalization involve s the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sample was drawn. Re searchers must be cautious in making gener alizations, because a sound generalization requires the support of many studie s with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 23

12. What best char acterizes the contribution of qualit ative nursing rese arch to e vidence-based practice?

(Select all that apply.)

a. It presents collective common evidence of health care clients experiences, which may provide inspirations for individual practice.

b. It provides stories of how health care clients feel. This lets nurses know what people in similar circumstances can be expected to experience.

c. It provides evidence that determines how nurse s should interact with various cultures.

This mandates action.

d. It generates and tests theory. e. It reveals participant s experiences and individual viewpoints, feelings, and

interpretations. These can provide guidelines for client-centered care.

ANS: A, E Qualitative re search is a systematic, interactive, subjective approach used to de scribe life experiences from the research participant s point of view. This type of re search is conducted to explore, describe, and promote understanding of human experiences, eve nts, and cultures over time. It is holistic and describe s the human in context.

Chapter 3. Introduction to Quantitative Research MULTIPLE CHOICE

1. A researcher conduct s a study which outline s the daily habit s of women who are overweight. This study represents what type of research? a.Correlational b.Descriptive c.Experimental d.Quasiexperimental ANS: B Feedback ACorrelational research investigates the relationship between or among variables.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental research is an objective, systematic, highly controlled investigation for the purpose of predicting and controlling phenomena.

DThe purpose of quasi-experimental rese arch is to examine causal relationships or determine the effect of one variable on another. Thus, these studie s involve implementing a treatment or intervention and examining the effects of this intervention using selected methods of measurement.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp.

32-33

2. The researcher wants to le arn whether there is a relationship between parental education and emergency room use among children who have asthma. Which type of research study will this researcher use? a.Basic b.Correlational c.Historical d.Phenomenological ANS: B Feedback ABasic research is scientific investigation that involves the pursuit of knowledge for knowledges sake.

BCorrelational research investigates the relationship between or among variables.

CHistorical research is a type of qualitative research.

DPhenomenological research is a type of qualitative rese arch.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 32-33

3. The nurse evaluates a research study that examines the relationship between computer and television screen time and obesity. A correlational analysis reveals a correlation of +0.95. What can the nurse conclude about the relationship between these two variables? a.An increase in screen time causes obesity. b.An increase in obesity leads to increased screen time. c.Screen time and obesity vary in opposite directions. d.Screen time and obesity vary together.

ANS: D Feedback AVariables that vary in opposite directions will have a negative correlation.

BDescriptive research is the exploration of phenomena in real-life situations.

CCorrelational studies do not indicate cause, so an increase in screen time or an increase in obesity does not cause or lead to an increase in the other.

DA positive correlation between variables indicates that the variables vary together. PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 33-34

4. In which type of research doe s the researcher see k to examine causal relationships among variable s without being able to manipulate the variables? a.De scriptive b.Correlational c.Experimental d.Quasiexperimental ANS: D Feedback ADescriptive research is the exploration of phenomena in real-life situations.

BCorrelational research investigates the relationship between or among variable s but does not attribute cause.

CExperimental design is considered the most powerful quantitative de sign because of the rigorous control of variables.

DQuasi-experimental studies have less control than experimental studie s, but they do exhibit some degree of control.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 34

5. The nurse participates in data collection for a clinical drug trial in which subjects are randomly assigned to either a treatment or a placebo group to measure the effects of the drug on a specific outcome. This is which type of study? a.Correlational b.De scriptive c.Experimental d.Quasiexperimental ANS: C Feedback ACorrelational research inve stigates the relationship between or among variable s but does not attribute cause.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental design involves control of variable s and random assignment of subjects so that effects of variables on specific outcomes can be measured.

DQuasi-experimental studies have le ss control than experimental studies, but they do exhibit some degree of control.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 34

6. A researcher studie s the effect of asthm a action plans on frequency of emergency de partment visits for asthma-related symptoms. The study would be described as: a.applied research. b.basic research. c.descriptive research. d.phenomenological research.

ANS: A Feedback AApplied research involves research that is directly applicable to clinical practice.

BBasic research is scientific investigation that involves the pursuit of knowledge for knowledges sake.

CDescriptive research is the exploration of phenomena in real-life situations.

DPhenomenological rese arch would not inve stigate this type of research que stion. Phenomenological research asks what is the lived experience of the person in this situation?

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 35

7. Basic research seeks to: a.directly influence clinical practice. b.gener ate knowle dge for knowle dges sake . c.predict or control outcome s of variables. d.validate or test theoretical frameworks.

ANS: B Feedback AApplied research is used to solve problems, make decisions, or predict or control outcomes in real-life practice situations.

BBasic research is more likely to be found in a labor atory setting and generates knowledge for knowledges sake. It may be used as the foundation for other research.

CExperimental research is conducted in order to be able to predict or control outcomes DGrounded theory research is used to validate theoretical frameworks.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 35-36

8. When developing a study, a re searcher establishes rule s for measurement of independent and dependent variables in order to minimize the possibility of error. This is an example of: a.control. b.manipulation. c.precision. d.rigor.

ANS: A Feedback AControl involve s the imposing of rules by the rese archer to decrease the possibility of error and thus increase the probability that the studys findings are an accurate reflection of reality.

BManipulation is when the researcher makes changes in the treatment received by the subjects.

CPrecision encompasses accuracy, detail, and order and is evident in the concise st atement of the research purpose.

DRigor is the discipline, attention to detail, and precision necessary when striving for excellence in research.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: pp. 3637

9. In which type of research study does the researcher have the most control? a.Correlational b.De scriptive c.Experimental d.Quasiexperimental ANS: C Feedback ACorrelational research inve stigates the relationship between or among variable s but does not attribute cause.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental design involve s control of variables and random assignment of subjects so that effects of variables on specific outcomes can be measured.

DQuasi-experimental studies have less control than experimental studie s, but they do exhibit some degree of control.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF:MCS: 34| pp. 36-37

10. A researcher de signs a study to e valuate stress and anxiety associated with breast feeding in which dat a collection takes place in the homes of mothers with premature newborns after discharge home from the NIC. This would be an example of which type of research setting?

a. Highly controlled, field b. Highly controlled, laboratory c.Natural, field d.Partially controlled, laboratory ANS: Feedback AThere are three common settings for conducting research: natural, partially controlle d, and highly controlled. A highly-controlled setting would involve experimental control of an independent variable, which this study does not do.

BThis is a field study, with data collection occurring in patients homes and not in a laboratory. CThe setting describes where the research and dat a collection occur. A natural setting, or field setting, is an uncontrolled, real-life situation or environment , such as the home. In a natural setting, there is relatively little control over the setting and the variables associated with the setting.

DThere are three common settings for conducting research: natur al, partially controlled, and highly controlled.

A natural setting, or field setting, is an uncontrolled, real-life situation or environment . This is a field study, with data collection occurring in patients homes and not in a laboratory PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

36-37

11. When conducting a research study using a convenience sam ple of all first grade students from two classrooms in a nearby school, the nurse researcher may increase the sample controlby: a.assigning one classroom to the experimental group and the other classroom to the control group. b.exposing all subjects to the treatment variable and then comparing the outcome dat a to pretreatment data. c.randomly assigning students from both classrooms to either the experimental group or the control group. d.using all of these subjects as treatment subjects and com paring outcomes to a group of subjects from a similar study.

ANS: C Feedback AAssigning one classroom t o one gr oup and the other classroom to the other group is le ss effective than random sampling.

BPre- and post-treatment comparison may be used when random assignment is not possible.

CRandomly assigning subjects to either a treatment group or a control group improves sam ple control and decreases bias. Even when convenience sampling is used, subjects may be randomly assigned to groups.

DCom paring a treatment group to a group in another study does not control the treatment variables because of variations between two studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 37

12. A nurse is assisting with data collection for a study measuring the effects of a sleep aid me dication on oxygen saturations. Subjects will sleep in a darkened room in a sleep lab while participating. Which type of research setting is this?

a. Field b. Highly

controlled c.Natural d.Partially controlled ANS: B Feedback AField settings are uncontrolled, real-life situations or environments.

BA highly controlled setting is one in which the influence of extraneous variable s is gre atly reduced.

Examples of such a setting would include labor atories, research or experimental centers, and test units in hospitals.

CNatural settings are uncontrolled, real-life situations or environments.

DPartially controlled settings are environment s that the rese archer has m anipulated or modifie d in some way.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 38

13. A nurse rese archer explains the relationships between research processe s and the nur sing process to a group of graduate-le vel nursing stude nts. Which statement by a nursing student indicates the need for further teaching? a.Nursing rese arch leads t o evidence -based nursing pr actice guideline s. b.Nursing research has a broader focus than the nursing process. c.The nursing proce ss helps to identify potential nursing research problem s. d.The nursing process requires rigorous application of research methods.

ANS: D Feedback ANursing research may be used to develop evidence-based nursing practice guidelines.

BNursing research has a br oader focus than the nursing process and is generally population based rather than individual based.

CThe nursing process can help to identify nursing research problems.

DThe nursing process may be based on research, but does not require the rigorous application of rese arch methods.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 38

14. Research subjects in a study of body im age after mastectomy will com plete a questionnaire about body image after surgery. Which assumption would the researcher likely make when conducting this study? a.All m astectomy patients are likely to be negatively affected by the surgery. b.Body image and appear ance are important to survivors of breast cancer. c.Subjects will be able to describe a personal awareness of body image . d.Subjects will complete every item on the questionnaire.

ANS: C Feedback AThe researcher does not indicate that negative effects of mastectomy are an assum ption of the study. The results of the study may indicate whether this is true or not.

BThe researcher does not indicate that the importance of body image an appe arance is an assum ption of the study. The results of the study may indicate whether this is true or not.

CAssumptions are statements taken for granted or considered true, even though they have not been scientifically tested. The researcher will assume that subjects have an awareness of this concept.

DThe researcher doe s not indicate that this is an assum ption of the study. It is undoubtedly hoped for to get complete data.

PTS: 1 DIF: Cognitive level: Underst anding (Comprehension) REF: pp. 4243

15. Statements that will be scientifically tested as part of a research study are called: a.assumptions. b.hypothe ses. c.limitations. d.variables.

ANS: B Feedback AAssumptions are statements that are taken for granted or considered true, even though they have not been scientifically tested.

BHypotheses are the researchers best guess as to the outcome of the study.

CLimitations are factors in the study that cannot be controlled or m anipulated, but might have an influence on the outcome.

DVariable s are the factors influencing the hypothe ses that the researcher wants to inve stigate. PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 42-44

16. A study that analyzes the effect of exercise on diabetes control among Native -American children with type II diabetes would most credibly be generalizable to which population?

a.African-Americans with type II diabetes b.NativeAmerican children with type I diabetes c.Children with type II diabetes d.All people with type II diabetes ANS: B Feedback A The population that the sample represents does not include all African-Americans with type II diabetes.

B Generalization is the extension of the implications of the research findings from the sample to a larger population. The population represented in the study is Native-American children, so the results of this study may be generalized to this population.

C The population that the sample represents does not include all children with type II diabetes.

D The population that the sample represents doe s not include all patient s with type II diabetes. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 46

17. To evaluate dat a collection methodology prior to conducting a large -scale study, a researcher might carry out a smaller-scale study. This smaller-scale study is known as a/an: a.abstr act. b.explor atory c.pilot d.proposal.

design. study.

ANS: C Feedback AThe abstract is a synopsis of the study found at the beginning of a research report.

BExploratory design is used when the total situation is unclear.

CA pilot study is frequently defined as a sm aller version of a proposed study conducted to refine the methodology.

DA proposal is a form al request to conduct a study; it can be submitted to obtain funds or get feedback on the studys methodology.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 45

18. The nurse researcher is developing a study to examine the effects of asthm a education on missed school days am ong grade school children. When de fining the research problem in the research proposal, the nurse will discuss: a.the proposed methodologies for data collection. b.st atistics about the number of school days missed by children with asthm a. c.the costs and types of various medications to treat asthma symptoms. d.the need for future studies to examine asthma care for this population.

ANS: B Feedback A The discussion about proposed methodologies is part of the study design.

B When describing the research problem, the rese archer identifies an area of concern for a particular

population.

C The costs and types of medications would be included in background inform ation, but this discussion does not identify the research problem.

D The discussion about the need for further studies is part of the discussion and summary.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 41

19. Which portion of a research report would the nurse initially read to get an overview of thestudy? a.Abstract b.Conclusion c.Framework d.Methodology ANS: A Feedback AThe research report usually begins with an abstract: a cle ar, concise summary of a study, including the research problem and purpose, methodology, and conclusions. The reader can gain an understanding of the study by reading the abstract.

BConclusions are presented at the end of the report and describe the findings based on the data collection and data analysis.

CThe framework is present later in the study report and tells about the foundation of the study.

DThe methodology is in the middle part of the report and describe s the study methods, tools, dat a collection, and analysis.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 51

20. The section of a research report that describes the purpose of a research study will include: a.what relationships among key variable s will be examined. b.which various theories provide context for the research problem. c.what is currently understood about the research problem. d.why the research is necessary to help close a gap in knowledge.

ANS: A Feedback AThe research purpose is a statement generated from the research problem identifying the specific focus of goal of the study.

BThe theoretical framework identifies how theories provide context for the research question.

CThe literature review identifies what is currently known about the research problem.

DThe research problem is a statement about why the research is necessary to close gaps inknowledge.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 41

21. A researcher conducts a review of relevant literature prior to developing a research study inorder to:

a.avoid duplication of research ideas. b.determine which theoretical framework is best adapted to the research problem. c.determine which type of study would be most cost-effective. d.identify what is known and unknown about a particular problem.

ANS: D Feedback AThe literature review identifies what is known and may describe past studies, but is not necessarily performed to avoid duplication of research ideas since m any studies are replicated in order to confirm results.

BThe literature review does not evaluate the theoretical framework.

CThe literature review does not determine cost-effectiveness of a study.

DThe literature review is conducted in order to identify what is alre ady known about a research problem and to document why a research study needs to be conducted.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

41-42

22. In a qualitative study to describe stages of grief, the researcher asks parents who have lost a child to cancer to describe their experiences with grief at specific time intervals after their childrens deaths. Which assumption will the researcher make? a.Study subjects have knowledge about theoretical concepts about grief. b.Study subjects understand the concept of grief. c.Subjects will be able to articulate their feelings coherently. d.Subjects will be available for data collection at specific time intervals.

ANS: B Feedback ASubjects who know what grief is do not necessarily have an understanding of theoretical conce pts about grief.

BA researcher may make an assumption that study subjects will understand the concept of grief.

CAlthough it is desired that subjects will be able to articulate their feelings or be available at specific intervals, there is no assumption that they will be able to do so.

DSubjects may not always be available at specific intervals. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 42-43

23. How is theory tested in quantitative research? a.Assum ptions about the theoretical framework are evaluated. b.Concepts become more clearly defined as they are tested. c.Relationships among concepts are tested. d.The entire theory is proven or disproven.

ANS: C Feedback AAssumptions are statements that are taken for granted and are not tested in research.

BConcepts are defined prior to initiating research.

CIn quantitative research, relational st atements between two or more conce pts are tested, not the entire

theory.

DQuantitative studies do not prove or disprove an entire theory, just relationships among key concepts.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

42-43

24. An operational definition of a variable or concept ensures that the variable or concept will be: a.given theoretical meaning. b.linke d to other variables or concepts. c.measured or manipulated. d.understood in context of a theoretical framework.

ANS: C Feedback AA conceptual definition of a concept gives that concept theoretical meaning.

BThe research question links concepts and variables to other concepts and variables.

CAn operational definition of a concept allows the concept to be measured or manipulated.

DThe operational de finition doe s not necessarily give meaning to a concept in the context of a theoretical framework.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 44

25. In a research proposal, when describing a research design, the researcher would include: a.discussion of a the oretical framework. b.evaluation of the researcher s expertise. c.methods for measurement of variables. d.purpose of the study.

ANS: C Feedback A The theoretical framework is discussed in the theory section.

B The evaluation of the researchers expertise is part of the discussion.

C In the research design, the researcher will describe how variables are measured along with sampling procedures and plans for data collection and analysis.

D The purpose of the study is discussed in the introduction and pur pose section.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 45

26. Prior to initiating a large-scale rese arch study, the researcher conduct s a sm all-scale study using similar subjects, methods, instruments, measurements, and analysis. This is done in order to: a.de fine the conceptual framewor k of the study. b.determine the quality of the study components. c.link study variables to one another. d.provide a study design.

ANS: B Feedback A The pilot is not performed to define the conceptual framework of the study.

B A pilot study is performed on a sm aller scale in order to determine the quality of the study components before the study is conducted on a larger scale.

C The pilot does not necessarily link study variable s to one another and is not the purpose of performing a pilot study.

D The pilot study tests components of the study de sign, which has already been determined.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 45

27. The methodology portion of the research report is used to: a.describe the study design. b.discuss the implications of the study. c.pr ovide a theoretical framewor k for the study. d.summ arize the purpose, methods, and results.

ANS: A Feedback A In the methodology section, the researcher de scribes the study de sign including sampling methods, measurement of variables, data collection, and data analysis.

B The implications of the study are explored in the discussion section.

C The theoretical framework is discussed in the introduction.

D The summary is discussed in the conclusion.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 45

28. When the researcher describes the population of a study, the rese arch consumer underst ands that this represents: a.all members of the population at large. b.all people who meet inclusion criteria for the study. c.members of the study gr oup and the control group. d.subject s selected for the study based on sampling techniques.

ANS: B Feedback AN mo bterasllom fe the population at large meet inclusion criteria and those who do not are not considered part of the population being studied.

B The population is all people who meet inclusion criteria for the study whether they are sample d and included or not.

C Members of the study and control group are the sample of the population selected for participation in the study.

D Subjects selected for the study are a representative sam ple of the population.

PTS:1DIF:Cognitive level: Applying (Application)

REF: MCS: 46

29. When a researcher describes an instrument as being valid this indicates that the instrument: a.accurately measures a variable. b.consistently measures variables across studies. c.has been described as high quality by other researchers. d.has been routinely used in other, similar studies.

ANS: A Feedback AWhen an instrument is valid, it is considered to be accurate. BReliability of an instrument means that it is consistent across studies. CQuality of the instrument is not defined by validity measures.

DFrequency of use of the instrument is not defined by validity measures.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 46-47

30. When noting the limitations of a rese arch study, the nurse might make which observation? a.Abstract concepts were defined using concrete, consistent terms. b.Findings could not be generalized to a population not included in the study. c.The researcher included a discussion of the links between the studys variable s. d.The subject s were randomly assigned to control and experimental groups.

ANS: B Feedback AThe definition of concepts does not address the limitations of a study.

BLimitations are restrictions in a study methodology or framework that may decrease the credibility and generalizability of the findings.

CThe theoretical framework contains a discussion about the links between study variables.

DRandom assignment to control or experimental groups increase s the likelihood that the studys findings m ay be generalized to a larger population.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp.

47-48

31. The purpose of a study abstract is to: a.describe the reason for conducting the study. b.outline the theoretical fr amework that define s the study. c.summarize a study concisely and capture the readers attention. d. summarize previous research about the studys topic.

ANS: C Feedback A The research purpose describes the reason for conducting the study.

B The theoretical framework clarifies links among variables.

C An abstract is a clear, concise summ ary of a study which, researchers hope, will capture the readers

attention.

D The literature review summarizes previous research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 51

32. In a study about concussion recovery in high school football players, which statement would be part of the introduction? a.The Functional Independence Measure was used to measure postconcussion symptom s. b.The purpose of this study was to determine average length of recovery time after a first concussion. c.The results of this study showed an aver age recovery time of 6 weeks among football players. d.The study included a convenience sample of high school football players in a five-county area.

ANS: B Feedback A The methods section contains descriptions of the tools used as well as the sampling methods.

B The introduction section contains a statement about the study purpose.

C The conclusion section includes statements about the results of the tests performed.

D The methods section cont ains descriptions of the tools used as well as the sampling methods.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 52

33. If a nur se wishes t o critically appr aise a studys sampling criteria and measurement tools, the nur se will read which part of the study report? a.Abstract b.Introduction c.Methods d. Results ANS: C Feedback A The abstract contains a concise description of the entire study.

B The introduction section contains a statement about the study purpose.

C The methods section contains descriptions of the tools used as well as the sampling methods.

D The results section includes statements about the results of the tests performed.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 53

34. To learn whether there is a statistically significant difference between the control group and the experimental group in a study, the nurse would review which section of the research report? a.Introduction b.Methods

c.Purpose d.Results ANS: D Feedback AThe introduction section contains a statement about the study purpose.

BThe methods section contains descriptions of the tools used as well as the sampling methods.

CThe purpose section contains a discussion of the reason for conducting the study.

DThe results section includes statements about the result s of the tests performed and includes statements about the statistical significance of the differences among the variables.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: MCS: 53

35. To help determine the relevance of a study t o practice, it is recommended that the reviewer read which two sections of the study initially? a.Abstract, discussion b.Conclusions, references c.Literature review, purpose d.Methods, results ANS: A Feedback AScanning the abstract or introduction and then the discussion will give an overview of the studys findings.

BThe conclusions and references may be read partly or in full after skimming the abstract and discussion.

CThe literature review and purpose may be read partly or in full after skimming the abstract and discussion.

DThe methods and results may be read partly or in full after skimming the abstract and discussion.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

54-55

36. The author of a research report describes the research problem in order to: a.conceptualize the research project. b.guide the de velopment of the study methods. c.determine the goals and focus of the study. d.identify gaps in knowledge.

ANS: D Feedback AThe theoretical framewor k serves to conceptualize the research project. BThe methodology section outline s the development of study methods. CThe research purpose identifies the goals and focus of the study.

DThe research problem statement identifies gaps in current knowle dge about the subject.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 52-53

MULTIPLE RESPONSE

1. Which of the following are true statements about quantitative research? (Choose all that apply.) a.Correlational research involve s the use of st atistics to determine relationships am ong variables. b.Experimental research is the only type of quantitative research that is valid. c.Quasi-experimental research is a useful option when controlled conditions are not possible . d.Statistical tests are employed with quantitative research studies.

ANS: A, C, D Feedback Correct Correlational research involves statistical analysis of variables using correlational statistics.

Quasi-experimental research is a useful option when controlled conditions are not possible.

Statistical tests are employed with quantitative research studies.

Incorrect Experiments are only one form of quantitative research. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 33

2. What study design involves no intervention on the part of the researcher? (Choose all thatapply.) a.Correlational b.De scriptive c.Experimental d.Quasiexperimental ANS: A, B Feedback Correct A correlational study does not involve interventions by the researcher.

A descriptive study does not involve interventions by the researcher.

IncorrectAn experimental study involves a highly controlled intervention.

A quasi-experimental study involves a controlled intervention.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp.

36-37

3. The nurse researcher submits a proposal for an initial study to e valuate the effects of regular moderate exercise on asthm a control scores in adolescent s with asthma. To achieve increased control in the initial study, the researcher will do which of the following? (Select all that apply.) a.Ask subject s to keep tr ack of time spent exercising in a journal. b.Have subjects exercise on treadmills in the clinic three times weekly. c.Choose subjects classified as having moderate intermittent asthma sym ptoms. d.Limit participants to adolescent males who have asthma.

ANS: B, C, D

Feedback Correct To control variables, the researcher should have subject s participate in the action in as controlle d a setting as possible.

Having participants exercise in the clinic allows for better control and e valuation of the degree of exercise.

Limiting subjects to those who have similar symptom s will help limit extraneous variables that might be attributed to differences in asthma severity or any differences attributed to gender.

IncorrectAsking subjects to record unsupervised exercise limits the degree of control of this variable.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 37

4. The nurse participates in data collection in a study comparing the effect of two antilipidemia medications on total chole sterol in patients with hyperlipidemia. Which are extraneous variables to consider in such a study? (Select all that apply.) a.Difference s between the antilipidemia b.Family history of hyperlipidemia. c.Individual patients weight s. d.Other serum lipid values.

medications.

ANS: B, C, D Feedback Correct One variable that can affect the study outcome is family history of hyperlipidemia in study participants.

Patients who are obese may have different outcomes related to this variable than the reactions of those who are not obese.

Other serum lipid values, such as high-density lipoproteins or low-density lipoproteins, can affect total cholesterol.

IncorrectThe differences between the two medications are controlled in this study and are not extraneous variables.

Chapter 4. Introduction to Qualitative Research MULTIPLE CHOICE

1. What role does qualitative research play in evidence-based practice (EBP)? a.Because it does not involve random-controlled trials (RCTs), it does not contribute directly to EBP. b. It offers a systematic approach for yielding insights into human experience and behavior. c. It provides a way to measure and evaluate quality outcomes that affect patient care. d. It provides the basis for most EBP guidelines and patient care protocols.

ANS: B Feedback A Many insights gained through qualitative studies are used to develop theories on which RCTs may be based.

B Qualitative research offers a systematic appr oach for collecting data about and evaluating human

perception and experience that cannot be achieved through experimental research.

C Qualitative research is not concerned solely with outcome s research, which looks at the effect s of nur sing interventions on patient care outcomes.

D RCTs are the basis for most EBP guidelines and protocols PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 67

2. A researcher identifies a socioeconomic group of pe ople to study. After developing a rapport with key members of the group, getting information about group members from the key members, and spending time working am ong gr oup members, the researcher develops theories about the group based on this experience.

Which type of qualitative research does this represent? a.Ethnographic b.Grounded the ory c.Historical d.Phenomenological ANS: A Feedback AEthnogr aphic re search was de velope d by anthropologists as a mechanism for studying cultures and involve s immersion in the group in order to make observations and get information.

BGrounded the ory research is an inductive technique that emerged from the discipline of sociology.

Ethnographic research was developed by anthropologists as a mechanism for studying cultures.

CHistorical research examines events of the past. Ethnogr aphic research was developed by anthropologists as a mechanism for studying cultures.

DPhenomenological rese arch describes experiences as they are lived. Ethnogr aphic rese arch was developed by anthropologists as a mechanism for studying cultures.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

74-75

3. What is true about phenomena in qualitative research? a.Human behavior is generally the result of the direct influence of inde pendent variable s. b.Knowledge gained by qualit ative research is concrete and derived from st atistical dat a. c.Multiple realities are possible based on meanings created by individuals and groups. d.Time and context have very little influence on individual or group perspectives.

ANS: C Feedback AHuman behavior is complex and not just the result of the influence of independent variables.

BKnowledge gained in qualitative research is less concrete than that gained through quantitative research.

CThe underst anding of phenomena in qualitative re search is not the same as in quantitative rese arch. In qualitative research, multiple realities, based on individual and group me anings, m ay be derived fr om research data.

DPhenomena in qualitative research are considered unique to the individual and in the time and the context that they occur.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 67

4. A researcher conducts a qualitative study and learns that individuals have a variety of reactions to an event. What can the researcher conclude from this finding? a.The findings are interesting, but are not useful for theory development. b.The reactions describe d in this study m ay be generalize d to a larger population. c.The study has little significance since there is no well-de fined single outcome. d.The variety of reactions is expected since perception varies with individuals.

ANS: D Feedback AFindings in qualitative studie s are often used to guide initial theory development whose constructs are later tested through experimental studies.

BReactions in qualitative studies do not have statistical significance and cannot be generalize d to a larger population.

CEven without a well-defined outcome, the results do have significance and contribute to the larger body of scientific knowledge.

DBecause meaning is subjective, there can be multiple realities in qualitative rese arch, which see ks to learn how individuals and groups respond to experiences.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 67

5. A researcher develops a study to examine various phenomena that contribute to theory development. This is an example of which type of research? a.Ethnographic research b.Grounded theory re search c.Historical re search d.Phenomenological research ANS: B Feedback AEthnogr aphers observe and document interactions within a culture.

BGrounded theory de velops theory directly from the research data.

CHistorical research examines events of the past.

DPhenomenological research attempts to capture the lived experience of study participant s.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 67| MCS: 70

6. A researcher conduct s a study to examine the feelings of cancer patient s at various point s during their disease, including at diagnosis, when beginning chemother apy, and during remission. Which type of study will the researcher use for this study? a.Ethnographic b.Grounded The ory c.Historical d.Phenomenological ANS: D Feedback A Ethnographers observe and document interactions within a culture. B Grounded theory de velops theory directly from the research dat a. C Historical research examines events of the past.

D Phenomenological rese arch attempt s to capture the lived experience of study participants.

PTS:1DIF:Cognitive level: Applying (Application) REF:MCS: 67| pp. 69-70

7. What is true about scientific rigor in qualitative nursing research? a.Studies are rigorous only when results are quantifiable. b.Study findings are considered trustworthy when rigor is applie d. c.Scientific rigor is not applicable with qualit ative studie s. d.Scientific rigor is only used with random-controlled trials.

ANS: B Feedback A Rigor can be applied to qualitative research.

B Rigor is valued because the findings of rigorous studie s are seen as being m ore credible and of greater worth.

C Rigor can be applied to both qualitative and quantitative research.

D Rigor is used with qualitative research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS : 68

8. When designing a study, which has the greatest influence as a rese archer decides which type of qualitative study design to use? a.Funding and resources b.Literature review c.Population d.Research question ANS: D

Feedback AFunding and resources influe nce the size of the population and the types of measures that may be employed.

BThe literature review and the population do not influence the study design directly.

CThe literature review and the population do not influence the study design directly.

DDeciding which qualitative approach to use depends on the research question and the purpose of the study.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 68

9. A researcher wishes to learn about the experiences that women have when breast feeding their infant s in the workplace. Which type of study design will the researcher employ? a.Ethnographic b.Explor atory-descriptive c.Grounded theory d.Historical ANS: B Feedback AEthnographers observe and document interactions within a culture.

BExploratory-descriptive studies are used when researchers are exploring a new t opic or describing a situation.

CGrounded theory develops theory directly from the research data.

DHistorical research examines events of the past.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

76-77

10. A researcher who bases phenomenological research on Husserls philosophy will: a.incorporate personal biases int o conclusions and discussion of the research. b.interpret subjects experiences according to the researchers own biase s. c.place personal biase s aside when considering and reporting research findings. d.use personal biases to look for hidden meanings in research data.

ANS: C Feedback AThis is not an accurate statement.

BThis is not an accurate statement.

CAccording to Husserl, to capture the lived experience of study participant s, the researcher must set aside personal biases to describe the phenomena in a nave way.

Heidegger describes ways that personal biases are incorporated into qualitative research.

DThis is not an accurate statement.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: pp. 6970

11. What is a key element of hermeneutics in research? a.Analysis of documents and interviews to identify themes and subtheme s in data b.Bracketing of the researchers own perceptions for the duration of the study c.Description of phenomena without interpretation by the researcher d.Focusing solely on phenomena themselves without consideration of biases ANS: A Feedback AHermeneutics is a type of interpretive phenomenological research method that involve s textual analysis and identification of themes and subthemes pre sent in interviews and publishe d document s in light of the studys research questions.

BHusserl suggested that the researcher must bracket personal biases in order to examine the rese arch data. Husserl differs from Heidigger in this regard.Heidigger argued that it is im possible to set aside beliefs and biases.

CHeidiggers approach is interpretive and is part of hermeneutics.

DHeidigger believed that researcher s cannot set aside their biase s.

PTS:1DIF:Cognitive level: Analyzing (Analysis)

REF: pp. 69-70

12. When performing an external criticism of the document s used in hist orical research, the reviewer must determine whether the documents are: a.genuine or fraudulent. b.interesting or dull. c.well known or obscure. d.written by authors who are still living.

ANS: A Feedback AExternal criticism determines the validity of source material.

BWhether or not the document is interesting has little to do with the importance of the document.

CAs long as the document is genuine and of interest to the study, whether it is well known or not is irrelevant.

DAlthough it might be useful to know whether or not the writers of the document are living, this doe s not relate to external criticism.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

78-79

13. What is true about grounded theory research? a. It is a method used to quantify theoretical constructs in theory development. b. It is used t o further research in are as where much concrete data is already known. c.Study designs use a theoretical basis to develop the research questions. d.Theory is developed from the data collected during the research.

ANS: D Feedback AExperimental studies are used to quantify theoretical constructs to test theories.

BGrounded theory research is preliminary and is often used when little is known about a subject.

CTheory is developed from the research findings of grounded theory research.

DGrounded theory develops theory directly from the research data. PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 70

14. A researcher wishes to understand how inner-city Somali immigrants adapt health care practices into their experiences with the U.S. health care system. Which type of study approach will the researcher use? a.De scriptive-qualit ative b.Ethnographic c.Grounded theory d.Phenomenological ANS: B Feedback AExplorat ory-de scriptive studies are used when researchers are exploring a new t opic or describing a situation.

BEthnographic research involves observation and documentation of interactions within a culture.

CGrounded theory develops theory directly from the research data.

DPhenomenological research attempts to capture the lived experience of study participant s.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 70-71

15. Which is an example of an etic approach in an ethnographic study? a.A longitudinal study examining individual immigrants attitudes about health care b.A study about African tribal women and their feelings about HIV prevention c.A study comparing various ethnic groups folk health practices d.A study of differences between BSN- and AND-prepared nurses attitudes about health care ANS: C Feedback AA study of immigrants attitudes about health care is a phenomenological study.

BA study examining a particular cultural group is an ethnographic study.

CThe etic appr oach involves studying behavior from outside the culture and examining similarities and differences across cultures.

DA study of attitudes about health care is a phenomenological study.

PTS:1DIF:Cognitive level: Applying (Application)

REF: MCS: 74

16. Which qualitative study will call for an explorat ory-de scriptive study approach? a.An evaluation of clinical outcomes of standard nursing interventions b.An examination of the effects of a treatment on various ethnic groups c.A review of data in order to evaluate theoretical constructs d.A study on a topic about which little is known or understood ANS: D Feedback AOutcomes re search is concerned with clinical outcomes of st andard interventions. BComparing the effects of a treatment on two groups of subjects is a quasi-experimental de sign. CTheory testing uses data to evaluate theoretical constructs.

DExplorat ory-de scriptive studies are used when researcher s are exploring a new t opic or describing a situation.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp.

77-78

17. A researcher utilizes an emic approach in a research study in order to: a.gather data about lived experiences of individuals. b.trying to understand behaviors from within a culture. c.examine individual human behavior accor ding to personal biases. d.use techniques such as bracketing and intuiting.

ANS: B Feedback APhenomenological research attempt s to capture the lived experience of study participant s. The emic approach involves studying behaviors from within a culture.

BThe emic approach involves studying behaviors from within a culture.

CThe etic perspective studie s behavior s from outside the culture and examine s similarities and differences across cultures. (The emic approach involves studying be haviors from within a culture.) The ethnogr aphic approach looks at groups, not individual behaviors.

DBracketing and intuiting are technique s use d rather than the focus of a study. The emic appr oach involves studying behaviors from within a culture.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 74

18. The goal of grounded theory research is to: a.de velop theories and hypothese s based on rese arch findings. b.establish an ethnographic perspective on subjects. c.provide validity checks for construct s. d.test theoretical constructs and hypotheses.

ANS: A Feedback A Theory developed from grounded theory research is grounded in the data from which it was derived.

B An ethnographic perception of research is part of an ethnographic perspective . C Validity checks for constructs are not the concern of grounded theory rese arch. D Theory testing use s data to evaluate theoretical constructs.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 74

19. A researcher wishes to examine the experiences and feelings of siblings of children who have cancer in order to gain inform ation about this population. Which type of qualitative study method will the rese archer use? a.Ethnographic b.Explor atory-descriptive c.Grounded theory d.Historical ANS: B Feedback AEthnographic research involves observation and documentation of interactions within a culture.

BExploratory-descriptive studies are used when researchers are exploring a new t opic or describing a situation.

CGrounded theory develops theory directly from the research data.

DHistorical research use s historical documents to describe event s.

PTS:1DIF:Cognitive level: Applying (Application)

REF: pp. 77-78

20. When conducting historical research about the experiences of women refugees from the Sudan, the researcher interviews women who served as nurses among this population. These nurses represent: a.control group subjects. b.experimental group subjects. c.primary dat a sources. d.secondary data sources.

ANS: D Feedback AControl and experimental group subjects are used in experimental, quantitative, and not in qualitative studies.

BControl and experimental group subjects are used in experimental, quantitative , and not in qualitative studies.

CPrimary data sources are those gathered directly from the study subjects and can either be from direct interviews or from diaries or other documents written by the subjects.

DA secondary data source can be a person who lived at the same time or who had contact with the subjects of the study. Nurses who cared for Sudane se woman immigrants would be secondary sources for this population.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

78-79

21. When conducting research about the experiences of early advanced practice nurse s, the rese archer may consult which possible secondary source? a.A textbook hist ory of early advanced practice nurse s b.Currently practicing advanced practice nurses c.Former patients of early advanced practice nurses d.The scope of practice guidelines for advanced practice nursing ANS: C Feedback AA textbook history may itself use primary and secondary data sources.

BCurrently practicing APRNs rely on primary and secondary sources for their information, but are not themselves sources of historical information.

CA secondary data source can be a person who live d at the same time or who had contact with the subjects of the study.

DThe scope of practice guidelines may use historical information, but it is not a historical document.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

78-79

22. What are subjects in qualitative research studies usually called? a.Experimental subjects b.Participant s c.Primary sources d.Secondary sources ANS: B Feedback AExperimental subjects are subjects who are part of experimental studies.

BSubjects in qualitative studie s are referred to as participants because the rese archer and the participants cooperatively carry out the study.

CPrimary sources are subjects in historical studies who actually lived the experiences beingdescribed.

DSecondary sources are people who knew or worked closely with primary sources in historical research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 8182

23. How are subjects selected for qualitative research studies? a.As volunteers through advertising for subjects b.Based on knowledge or experience c.By random sampling methods d.Through convenience sampling ANS: B Feedback ASubjects tend to be recruited and do not necessarily volunteer.

BSubjects in qualitative rese arch studies are selected base d on their knowledge or experience or for their views related to the study.

CRandom sampling techniques are not generally used in qualitative research.

DConvenience sam ples are used when random sampling techniques are not possible and generally in qualitative research. Subjects in qualitative research are selected based on knowledge or experience.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 82

24. What is the researcher-participant relationship in qualitative research? a.Attaching per sonal meanings of the researcher to subjects responses b.Controlling subjects response s by stating the aims of the study c.Creating empathetic and honest relationships with study subjects d.Keeping a distance to avoid skewing research findings ANS: C Feedback AIt is necessary for the researcher to be open to the perceptions of the participants.

BThe researcher tries to avoid controlling the subjects responses.

CIn qualit ative research, the researcher creates a respectful relationship with each participant that includes being honest and open about the studys purpose and methods.

DThe researcher does not maintain a detache d distance as with quantitative studies, but must become closely involved in the subjects experience in order to interpret it.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 82

25. What type of data collection method is most common in qualitative research? a. Distribution and review of questionnaires from subject s b.Interviews with and observation of subject s c.Participation and immersion in the lives of subjects d.Review of historical documents and literature about subjects ANS: B Feedback AQuestionnaires are used occasionally, but are often used in quantitative research as well.

BBecause the data in m ost qualit ative studies are the participants thoughts, ideas, and perceptions, dat a collection is most often done by interviewing and observing participants.

CEthnographic research is a less comm on type of qualitative research and involve s participation and immersion in the lives of subjects.

DHistorical research is a type of qualitative research that involves review of historical documents and literature.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 83

26. During a qualitative research study, a rese archer asks subjects a fixed set of questions to which the participants respond freely. This is an example of a(n): a.open-ended interview. b.semi-structured interview. c.structured interview. d.unstructured interview.

ANS: B Feedback AAn open-ende d interview is unstructured and, while the researcher define s the focus of the interview, there may be no fixed sequence of questions.

BA semi-structured interview involves a fixed set of questions with no fixed responses.

CA structured interview involves a fixed set of questions with a fixed set of answers.

DAn unstructured interview m ay not have fixed que stions or answers.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 83-84

27. What may characterize questions asked by the researcher during an exploratory-descriptive study? a.A focus on participants biographical information b.Using structured individual questions c.One main que stion with follow-up que stions d.Openended questions with probes to follow up ANS: B

Feedback AEthnographic researchers will focus on biographical data.

BIn an explor atory-descriptive study, the researcher m ay ask more structured questions t o achieve the purpose of the study.

CInterviews in a phenomenology study may have one main que stion with follow -up que stions used as needed to elicit the participants perspective on the phenomenon.

DPhenomenological rese arch interviews begin with open-ended que stions followed up with more probing questions to elicit participants perspectives.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

83-84

28. A researcher investigates how nurses in a rural hospital regard the importance of asthma education using an ethnographic approach. Why was this approach appropriate? a.To find out what it was like for nurse s to provide this education b.To explore the theoretical basis of asthma education c.To improve understanding of how the se nur ses define asthm a education d.To look at the history of asthma education to shed light on current practice ANS: C Feedback A A study to learn what it is like to do something would be best learned through an exploratory study.

B Grounded theory research explores the theoretical basis for interventions.

C The ethnographic approach looks at phenomena within a certain culture, in this case the hospital, and seeks to describe how that culture deals with the subject of interest.

D Historical research studies the history of an intervention. PTS:1DI F:Cognitive level: Analyzing (Analysis) REF: MCS: 74

29. When appraising a study in which data was collected by interview, the reviewer will assess for: a.adequate length of time for each interview. b.evidence that prompt s were not used to encourage responses. c.use of clinical setting for conducting interviews. d.utilization of payment for participation of subjects.

ANS: A Feedback A An important aspect of reviewing interview methods is t o assess the length of time the rese archer allowed for each interview to determine whether subjects had adequate time torespond.

B Prompts may be used in interviews.

C It is better if interviews are conducted in a natural, and not a clinical setting.

D Subjects will ideally be volunteers, recruited for their knowledge and experience.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 83

30. A researcher may choose to use a focus group inste ad of one -to-one interviews in order to: a.encourage free expression of views of the participants. b. increase conformity and consistency of participants responses. c.reduce the time needed to collect data. d.allow more time for lengthy and complete responses.

ANS: A Feedback A One of the assumptions underlying the use of focus groups is that group dynamics can help people to express and clarify their views in ways that are less likely to occur in a one-to-one setting.

B The goal of a focus group is not to increase conformity, but this may sometimes occur if participants go along with the group.

C This type of data collection often takes more time that with one-on-one interviews.

D Focus groups often do not allow for lengthy responses by individuals.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 85

31. When gathering dat a for a study using observational methods, it is important for the data collector to: a.be observant of all that is done and said and unsaid. b.direct subject s by setting the stage through structured que stions. c.record those actions and words that are related to the focus of the study. d.participate directly with subjects in order to better understand them.

ANS: A Feedback A During observational experiences, the rese archer should be observant and attempt to record what is said as well as unsaid and to record all that is done.

B The observer should not try to direct the actions of the participants.

C Unexpected events occurring during routine activities may be significant and are carefully noted.

D Ethnographic research involves immersion and participation. PTS:1DI F:Cognitive level: Analyzing (Analysis) REF: MCS: 86

32. To maximize collection of pertinent information when conducting an observational study, the rese archer records field notes: a.after the observation has concluded. b.during or immediately after the observation. c.prior to beginning the observation. d.when writing the research discussion.

ANS: B Feedback A This is not an accurate statement.

B In studies that use observation, notes taken during or shortly after observations (field notes) are best recorded while the information is easily recalled. It may be necessary to avoid taking notes during the observation so that the recorder does not miss observing something important.

C This is not an accurate statement.

D This is not an accurate statement.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 86

33. Which is true about data analysis in a qualitative study? a. It has very little structure. b. It is unnecessary in qualitative studies. c. It requires less time than with quantitative analysis. d. It should be consistent with the philosophical method of the study.

ANS: D Feedback AData analysis is as rigorous as with quantitative studies.

BData analysis is as rigorous as with quantitative studies and as important.

CDat a analysis may take more time in qualitative studies because dwelling with the data requires considerable reading and reflection of the data.

DData analysis in qualitative studies should be consistent with the philosophical method of thestudy.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 89

34. A researcher classifies words and phrases that occur in data collected in a qualit ative study. This pr ocess is called: a.coding the data. b.de scribing the data. c.dwelling with the data. d.interpreting the data.

ANS: A Feedback ACoding the data is the process of re ading the dat a, breaking text down into subpart s, and labeling that part of the text.

BDescribing the data requires less analysis of the data than coding.

CDwelling with the data involves spending time mulling over the data to read and reflect on itsmeaning.

DDuring interpretation, the researcher places the findings in a larger context and may link different themes or factors in the findings to each other.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 89

35. Which type of research uses a less formal method of reporting data? a.Ethnographic b.Grounded the ory c.Historical d.Phenomenological

ANS: C Feedback AReports of ethnogr aphic rese arch follow the traditional style. Hist orical rese arch reports do not follow the traditional formalized style that is characteristic of much research.

BReports of grounded the ory research follow the traditional style. Hist orical rese arch reports do not follow the traditional formalized style that is characteristic of much research.

CHistorical re search reports do not follow the traditional formalized style that is char acteristic of much research.

DReports of phenomenological research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS : 78

36. A researcher describes phrases and terms discovered in a qualit ative study and describe s and links these with various themes. This is an example of: a.coding the data. b.de scribing the data. c.dwelling with the data. d.interpreting the data.

ANS: D Feedback ACoding the data is the process of re ading the dat a, breaking text down into subpart s, and labeling that part of the text.

BDescribing the data involves stating the findings in meaningful terms.

CDwelling with the data involves spending time mulling over the data to read and reflect on itsmeaning.

DIn qualit ative research, data interpretation involves placing things discovered into categories that are linked with themes in order to identify meaning.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 89

37. While reviewing transcripts of interviews conducted for a qualit ative study, the researcher appraise s the data for congruence with the philosophical perspective of the study. This is an example of:

a.perspective. b.reliability. c.rigor. d.validity.

ANS: C Feedback A The perspective identifies the initial intent of the study.

B Reliability is used to evaluate measurement methods in quantitative research.

C Rigor in qualitative research requires critically appraising the study for congruence with the philosophical perspective.

D Validity is used to evaluate measurement methods in quantitative research. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 90

38. What is the purpose of qualitative research? a.To allow rese archers t o interject their own values into studies b.To describe data that cannot be measured or quantified c.To describe experiences and insight fr om the subject s perspective d.To establish causal relationships among subjective data ANS: C Feedback A Qualitative research often involves the interaction of the researchers and the subjects perspectives and values, but that is not the purpose.

B Measureable data may be included in qualitative research.

C Qualitative research seeks to study the experiences of subjects and to gain insights from their perspective and not that of the researcher.

D Qualitative research seeks to identify meaning and context and not cause and effect. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 90

39. How are findings from qualit ative studie s used to add to the body of nur sing knowledge? a.Findings are useful only for describing study subjects. b. Findings may be generalized to a wide variety of population groups.

c. Findings provide a broad overview from which meaning is derived. d. Findings reveal meanings that can be used to develop theory.

ANS: D Feedback AAlthough they describe the particular situation, they have relevance in theory de velopment . BFindings are particular to the situation being observed and do not provide a broad overview. CFindings are particular to the situation being observed and do not provide a broad overview.

DThe findings from a qualit ative study le ad to an underst anding of a phenomenon in a particular situation and are not generalized, but provide an initial picture or theory.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 67

40. A researcher uses film footage to collect data in which type of research? a.Ethnographic b.Grounded the ory c.Historical d.Phenomenological ANS: C Feedback AEthnogr aphers observe and document interactions within a culture. Historians m ay observe film , videotapes, photographs, or artistic representations of historical events.

BGrounded the ory develops the ory directly from the research data. Historians m ay observe film , vide otape s, photographs, or artistic representations of historical events.

CHistorians may observe film, videotapes, photographs, or artistic representations of historical events.

DPhenomenological research attempts to capture the lived experience of study participants. Historians m ay observe film, videotapes, photographs, or artistic representations of historical events.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 67|MCS: 78

41. Which is true about rigor in qualitative research? a.Data should be interpreted according to the initial expectations of the researcher.

b.Findings of the study should be generalizable to a larger population. c.Studies are evaluated based on de sign det ail and thoroughness of evaluation. d.There is no method for judging rigor in qualitative research.

ANS: C Feedback A The meaning of the dat a should be interpreted with an open mind, even if the meaning is not what was initially anticipated.

B The findings of a qualit ative study cannot be generalized but may be applied in other contexts or with other subjects.

C Rigor in qualit ative studie s is asse ssed based on the de gree of det ail in study de sign, the care taken in dat a collection, and the thoroughness of data analysis.

D Rigor is valued in all research as a means to ensure the credibility and worth of studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 68

42. Which is true about phenomenological research? a. It is a method that views the person and the environment as integrated. b. It seeks to quantify human behavior and experience. c. It disregards the meaning of lived experiences. d. It is a single approach that uses quantitative research methods.

ANS: A Feedback APhenomenological rese arch views the person as integrated with the environment.

BPhenomenological rese arch does not seek t o quantify hum an behavior and experience CPhenomenological research seeks to find and interpret the meaning of lived experiences. DThere are several philosophical approaches to phenomenological research.

Chapter 5. Research Problem and Purpose MULTIPLE CHOICE

1. A researcher has conducted 9 clinical studies, some quantitative and others qualitative, all of which focus on depre ssions relationship to perceived abandonment. Depressions relationship to perceived abandonment is an example of which of the following?

a. Research problem b. Research topic c. Research purpose d. Problem statement ANS: B Research topics are concepts, phenomena of interest, or broad problem areas that rese arch ers can focus on to enhance evidence-base d nursing. A research problem is an area of concern where there is a gap in the knowle dge base needed for nursing pr actice. Research topics contain numerous potential research problems, and e ach problem provides the basis for developing m any rese arch purpose s. The problem statement identifies the specific gap in the knowle dge needed for practice. A nursing situation often includes a variety of research topics or concepts.

DIF: Cognitive Level: Application REF: MCS: 73

2. Why is replicating a research study essential for knowledge development? a. Each time a study is replicated, its probability of error decreases. b. Reproducing a study decreases theoretical knowledge, increasing real knowledge. c. Replication helps confirm that the initial results were not reached in error. d. Replication studies represent the majority of published nursing literature.

ANS: C Replication involve s reproducing or repeating a study to determine if similar findings will be obtained.

Replication is e ssential for knowledge development because it (1) establishe s the credibility of t he findings, (2) extends the generalizability of the findings over a range of instance s and contexts, (3) reduces the number of type I and type II errors, (4) corrects the limitations in studie s methodologies, ( 5) supports the ory development , and (6) lessens the acceptance of erroneous results. S ome researchers replicate studies because they agree with the findings and wonder if the findings will hold up in different settings with different subjects over time. Others want to challenge the findings or interpretations of prior inve stigator s. Howe ver, the number of nursing studies replicated continues to be limited.

DIF: Cognitive Level: Synthesis REF: MCS: 77

3. A nurse researcher working in a subacute orthopedic hospital floor. She notes that her elders with knee replacements slee p as many as 16 hours a day, waking only for physical therapy and meals, but she also notices that those with many visitors sleep fewer hours and seem to experience more pain. She wonders whether sleep in elders after knee replacement prevents pain, or whether elders select the coping strategy of sleeping more, in response to pain, and begins to attempt to identify the relationship between the two. A literature search reve als only three descriptive studie s on this topic, one quantitative and two qualitative. W hat is the relationship between elder s hour s of sleep following knee replacement and it s relationship with report of pain?

a. The research aim b. The research purpose c. The research problem d. The research topic ANS: C Research topics are concept s, phenomena of interest, or br oad problem areas that rese archers can focus on to enhance evidence -based nursing. A research problem is an area of concern where there is a gap in the knowle dge base needed for nursing practice. Rese arch topics contain numerous potential research problems, and each problem provides the basis for developing many research purposes.

DIF: Cognitive Level: Synthesis REF: MCS: 73

4. A masters student who works in cardiothoracic ICU reads a 20-ye ar-old nur sing rese arch study; the findings document use of much larger per-kilogr am amounts of opioids and anxiolytics postoperatively in adults with ope n-he art surgery, as opposed t o children with open - heart surgery. The student strongly suspects that modern hospitals medicate children and adult s more or less the same, on a per-kilogr am basis.

She decides to replicate the original research in her hospital. What type of replication is this?

a. Exact replication b. Concurrent replication c. Systematic replication d. Approximate replication ANS: D Replication involve s reproducing or repeating a study to determine whether similar findings will be obtained.

Four different types of replication are im portant in generating sound scientific knowle dge for nur sing: (1) exact, (2) approximate, (3) concurrent, and (4) systematic extension. An exact , or identical, replication involve s duplicating the initial researchers study to confirm the original findings. All conditions of the original study must be maintained. An approximate, or operational, replication involves repeating the original study under similar conditions, following the methods as closely as possible. A concurrent, or internal, replication involves the collection of data for the original study and its simultane ous replication to provide a check of the reliability of the original study. A systematic extension or constructive replication is done under distinctly new conditions.

DIF: Cognitive Level: Application REF: MCS: 77

5. A research study contains the question, Can the application of twice-daily cortisone in the period from 6 to 10 weeks postoperatively produce significantly increased range of motion in 50- t o 60-year-old rot ator-cuff repair patients at the six-month mark? The study is

research.

a. Ethnographic b. Historical c. Experimental d. Basic ANS: C Experimental studies are conducted in highly controlled settings and under highly controlled conditions to determine the effect of one or m ore independent variables on one or m ore dependent variables. An experimental research question takes the form of, Does provision of

increased A have an effect on B? where the study variables are A and B, the relationship is a change in A and its effect on B, and the question ends with a question mark.

DIF: Cognitive Level: Synthesis REF: MCS: 87

6. A knowledge gap is identified by a nurse researcher. Which of the following m ay NOT nece ssarily represent a knowledge gap?

a. A literature search that shows that no quantitative research, but only qualitative research, exists in the area.

b. The National Institutes of Health (NIH) identify the area as one of research priority. c. The phenomenon of interest is a new disease, just identified in Phoenix, Arizona. d. There is one study examining a new intervention, but the research has not yet been replicated.

ANS: A The lack of quantitative research m ay mean only that the phenomenon or idea of the rese arch is not suited for quantitative research, since some concept s are suitable only for qualitative enquiry. By questioning and reviewing the literature, researchers begin to recognize a specific area of concern and the knowle dge gap that surrounds it. The knowledge gap, or what is not known about this clinical problem, determines the complexity and number of studies neede d to gener ate esse ntial knowle dge for nursing pr actice. Since 1975, expert researchers, specialty groups, pr ofessional organizations, and funding agencies have identified nursing research priorities.

DIF: Cognitive Level: Application REF: MCS: 87

7. Which of the following represents a concise, cle ar statement of the specific goal or aim of a research study?

a. The research problem was identified as the general area of ignor ance surrounding the causation and diagnosis of meningococcal meningitis, especially among soldiers in uniform, and this constituted a significant gap in the literature.

b. The purpose of the project, then, was to define changes in the variable of hypertension across time, with the four most prevalent treatment modalities prescribed by primary care physicians in the greater Chicago area.

c. The phenomenon of depression experienced by the primary schoolchild was focuse d upon in this study. It is an under-researched topic, especially since recent research has identified correlational li nks with childhood obesity, e specially Hispanic and African-American populations.

d. Despite the fact that studying the disease, especially from st andpoint s of prevention and early detection, is costly and time-consuming, it represents a cle ar priority, since treatment itself is remarkably costly and the afflicted are not likely t o experience even short remissions without early intervention.

ANS: B The research purpose is a concise, cle ar st atement of the specific goal or aim of the study that is generated from the research problem. A research problem is an are a of concern where there is a gap in the knowle dge base needed for nursing practice. Rese arch topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance e vidence-based nur sing. One source of rese arch problems is research priorities identified by funding agencies and specialty groups.

DIF: Cognitive Level: Comprehension REF: MCS: 74

8. What is the relationship between a research topic and a research problem? a. The purpose is the most general statement; the research topic is the most specific to the research itself.

b. Research topics cont ain numerous potential rese arch problems, and each problem provide s the basis for developing many purposes.

c. The research topic and the research problem are identical. d. The research topic specifies setting and population, but the problem does not.

ANS: A Research topics are concept s, phenomena of interest, or broad pr oblem are as that researchers can focus on to enhance evidence -based nur sing. Research topics contain numerous potential research problem s, and each problem provides the basis for developing many purposes. Thus, the

identification of a relevant rese arch topic and a challenging, significant problem can facilitate the development of numerous study purposes to direct a lifetime program of research.

DIF: Cognitive Level: Analysis REF: MCS: 73

9. Which of the following is the practicing nurses most important source of researchable problems? a. The nurses own clinical practice b. Review of the literature c. Nursing theories d. Administrative mandates to conduct clinical research on every hospital unit ANS: A The practice of nursing must be based on knowledge or evidence generated through research. Thus, clinical practice is an extremely important source for research problems. Problem s can evolve from clinical observations. A review of patient records, treatment plans, and procedure manuals might reveal concerns or raise questions about practice that could be the basis for research problems.

DIF: Cognitive Level: Analysis REF: MCS: 75 MULTIPLE RESPONSE

1. Which of the following are considered evidence-generating? (Select all that apply.) a. Replication of previous research b. Identification of research topics, followed by basic research c. Applied research studies that examine clinical response to interventions d. Reviews of the literature e. Qualitative research examining response s to diagnosis ANS: A, B, C, E

Research topics are concepts, phenomena of interest, or broad problem areas that rese archers can focus on to enhance evidence -based nursing. However, the lack of replication studie s severely limits the generation of sound research findings needed for evidence-based practice in nursing.

Basic, or pure, research is a scientific inve stigation that involve s the pursuit of knowle dge for knowledge s sake, or for the pleasure of learning and finding truth. The purpose of basic research is to generate and refine theory and build constructs; thus, the findings are frequently not directly useful in practice. Re plication of previously conducted re search is essential for knowledge development. By que stioning and reviewing the literature, researchers begin to recognize a specific area of concern and the knowledge gap that surrounds it; however, review of the literature does not generate knowledgeit reviews previous knowledge. Que stions focusing on investigating new techniques to improve existing skills, patient response s to techniques, or ways to educate patients and families t o perform techniques. . . could add to knowle dge needed for evide nce-base d practice.

DIF: Cognitive Level: Analysis REF: MCS: 73

2. Reasons to conduct an exact replication include which of the following? (Select all that apply.) a. A different sample is used in the replication, because subjects seldom elect to undergo the same surgical procedure twice.

b. The same site is again used, in order to decrease variation. c. Sample size was adequate, the design was strong, and measurements were robust. d. Validation of the truthfulness of the original subjects responses is desired. e. A similar population is used, in order to verify the findings.

ANS: B, C, D Four different types of replication are important in generating sound scientific knowledge for nur sing: (1) exact, (2) approximate, (3) concurrent, and (4) systematic extension. An exact (or identical) replication involve s duplicating the initial re searchers study to confirm the original findings. All conditions of the original study must be maintained. Ex act replications might be thought of as ideal to confirm original study findings, but these are frequently not attainable. In addition, one would not want to replicate the errors in an original study, such as small sample size, weak design, or poor-quality measurement methods.

DIF: Cognitive Level: Analysis REF: MCS: 77

3. The American Association of Critical Care Nurses (AACN) funds various rese arch projects that focus on its research priorities. A m asters student wants to initiate research to study the relative accuracy of new computer-assisted asse ssment de vice that painlessly measures blood glucose values through a probe just distal to the insertion hub of a central line, in patients on insulin drips with hourly Accu-Chek readings. Does this pertain to any of the organizations research priorities, listed here? (Select all that apply.)

a. Technology use to achieve patient assessment, management, or outcomes b. Prevention and management of complications c. Processes and systems that foster the optimal contribution of critical care nurses d. Creation of a healing, humane environment e. Development of processes and systems that foster the optimal contribution of critical care nurses ANS: A, D The American Association of Critical Care Nurse s (AACN) determined initial rese arch priorities for this specialty in the early 1980s and revised these priorities based on patient s needs and the change s in health care. The current AACN (2011) research priorities are identified on this organizations website as (1) effective and appr opriate use of technology to achieve optimal patient asse ssment, m anagement, or outcomes; (2) creation of a healing, humane environment; (3) processes and system s that foster the optimal contribution of critical care nur ses; (4) effective approache s to symptom management; and (5) prevention and m anagement of complications. This research study use s technology. Also, it saves the patient from interruptions in sleep, as the nurse flushes a line and draws blood hourly, or performs hourly Accu-Cheks, if the line will not draw.

DIF: Cognitive Level: Synthesis REF: MCS: 79

4. The purpose of the rese arch will be, most likely, to document how admirable charitable effort s by The Children of the Land were terminated by the well-meaning Los Angeles Police Force. What is incorrect about this wording? (Select all that apply.)

a. A police organization cannot be named in a research purpose. b. A purpose should specify methodology. c. The terms admirable and well-meaning are both subjective. d. The purpose must identify the goal of the study, not the most likely goal. e. The purpose should be stated as was or is but not will be.

ANS: C, D, E The purpose is generated fr om the problem, identifies the goal or goals of the study, and directs the development of the study. In the research proce ss, the purpose is usually st ated after the problem, because the problem identifies the gap in knowledge in a selected area and the purpose clarifies the knowledge to be generated by the study. The rese arch purpose must be stated objectively, that is, in a way that doe s not reflect particular biases or values of the researcher.

Investigator s who do not recognize their values might include their biases in the research. This can lead them to generate the answers they want or believe to be true and might add inaccurate information to a disciplines body of knowledge.

DIF: Cognitive Level: Evaluation REF: MCS: 83

5. Children in publicly funded school breakfast progr ams often have le arning delays. The se are not readily attributable to single causes. Research on learning delays has revealed that family literacy, measured by parental reading level and com prehension score s, is the most powerful predictor of delay in the primary grades. On the other hand, repeated exposure to eyes-on reading, in the company of a trusted non-parent adult, has been shown to over-ride family literacy as a predictor. No rese arch, howe ver, has studie d institution of a reading-and-breakfast progr am, delivered five days a week be fore school, intended to over ride the variable of family literacy. Given this problem statement, which of these purposes would be appropriate for the study? (Select all that apply.)

a. The purpose of the study was to determine whether providing volunteer readers during school breakfasts for all kindergarten and first-grade children would result in fewer than anticipated learning delays.

b. The purpose of the study was t o determine the lived experience of children with learning delays, against the context of school and home, and to examine the childrens peer relationships.

c. The purpose of the study was to determine whether a buddy system of one sixth- gr ader, and one kindergartner or first-grader, who ate breakfast together and then read together for 20 minutes, was effective in decreasing the anticipated number learning delays.

d. The purpose of the study was to experimentally determine what causes learning delays, by introducing various strategies already in place in community primary schools and measuring their effect, using basic research.

e. The purpose of the study was to measure the effectiveness of using school computers, allowing children to visually scan a story concurrently read by a school teacher over the cafeteria microphone during school breakfast time, in decreasing the incidence and severity of learning delays.

ANS: A, C, E The problem st atement identifies the specific gap in the knowle dge needed for practice. Each problem may generate many research pur poses. The research purpose is a clear, concise st atement of the specific goal or aim of the study that is generated from the rese arch problem. The purpose usually indicates the type of study to be conducted and often includes the variables, population, and setting for the study.

DIF: Cognitive Level: Synthesis REF: MCS: 73

6. In determining a studys fe asibility, which of the following st atements are true, regarding the time needed for study completion? (Select all that apply.)

a. Some data collection must be performed over an extended period of time, such as measurements of the depth and extent of scar tissue over 18 months.

b. Sufficient subjects meeting the study criteria m ay be difficult t o access, requiring data collection that extends for months or even years.

c. The inflationary spiral makes all research funding inadequate. d. Computerized records make data analysis much less time-consuming. e. Obtaining Institutional Review Board (IRB. approval may be time-consuming, especially if the research uses more than one hospital or agency.

ANS: A, B, E

One can approximate the time needed to complete a study by assessing the following fact ors: (1) type and number of subjects needed, (2) number and complexity of the variables to be studied, (3) methods for measuring the variables ( are instruments available to me asure the variables, or must they be develope d?), (4) methods for collecting dat a, and (5) the data analysis process. Another factor that can increase the time needed for a study is obtaining institutional review board (IRB) approval, e specially if more than one clinical agency is used for dat a collection in a study. Not all rese arch funding is inadequate.

Computerized records m ay be easier or may be more difficult for dat a retrieval; howe ver, data analysis is not affected by the existence of computerized data.

DIF: Cognitive Level: Application REF: MCS: 84

7. How do se asoned nur se researchers, ye ars away from clinical pr actice, select meaningful research questions? (Select all that apply.)

a. They continue to conduct research in the same general areas in which they have previously conducted research, with one project leading into the next.

b. They cannot do so, because they are not working bedside nurses. c. They establish wor king relationships with clinical nurse s, sharing author ship of rese arch publications.

d. They collaborate with novice researchers who are closer to the clinical world. e. They use research methods that allow data collection through only observation.

ANS: A, C, D Interactions with rese archers and peers offer valuable opportunities for generating rese arch problems.

Experienced researchers serve as ment ors and help novice researchers t o identify research topics and formulate problems. This type of relationship could also be developed between an expert researcher and a nurse clinician. Since nursing research is critical to be designated as a Magnet facility, hospitals and healthcare system s employ nur se researchers for the pur pose of guiding studies conducted by staff nurses. Building an evidence-base d practice for nursing requires collaboration between nurse researchers and clinicians, as well as collaboration with researchers from other health-related disciplines. During data collection, study variables are

measured through a variety of technique s, such as observation, interview, questionnaires, scale s, and physiological measurement methods.

DIF: Cognitive Level: Synthesis REF: MCS: 76

8. A masters student does not know how t o choose a rese arch problem. She has been off work for the past two years. What sources can she use in order to identify a rese archable nursing problem? Her work area used to be trauma nursing, but she doe s not wish to perform research in this area. By using which of the following sources can she identify a nursing research problem? (Select all that apply.)

a. Talking with nurse friends about questions that have arisen in their work areas b. Talking with other masters students about ideas for study c. Reading professional research journals d. Depending on her instructors to provide a research problem for her e. National Institutes for Nursing Research priorities ANS: A, B, C, E The major sources for nursing research problems include nursing practice; researcher and peer interactions; literature review; theories; and research priorities identified by individuals, specialty groups, professional organizations, and funding agencies.

DIF: Cognitive Level: Application REF: MCS: 75

9. What is the relationship am ong the research problem, the research purpose, and the research question?

(Select all that apply.)

a. The purpose is but one of many purpose s that can be generated from one particular problem statement.

b. The problem statement is more focused and specific than is the purpose. c. The research purpose and the research question should address the same facet of the research problem.

d. The problem, purpose, and que stion are all focuse d upon a specific gap in the knowledge base.

e. Research can be conducted without a research question, but not without a research purpose.

ANS: A, C, D A research problem is an area of concern where there is a gap in the knowledge based needed for nursing practice. A research problem include s significance, backgr ound, and a problem st atement. The problem statement identifies the specific gap in the knowledge neede d for pr actice. The research purpose is a cle ar, concise statement of the specific goal or aim of the study that is generated from the re search problem, so the purpose is usually identified after the research purpose is identified. Consequently, more than one purpose can emanate from a give n problem statement. Based on the research purpose, specific rese arch objectives, questions, or hypotheses are developed to direct the study.

DIF: Cognitive Level: Analysis REF: MCS: 73

10. A researcher gains support of the medical staff, the nursing staff, and the nurse manager of a cardiothor acic ICU within a prestigious private hospital, aligne d with a teaching institution. A research proposal, concerning am bulation patterns after bypass surgery, is approved by the Human Subjects Committee. Federal funding is obtained. Just before data collection is to begin, the hospital is sold to a large university with a medical school, the nurse manager is replaced with a manger from another hospit al in the corporation, and there is a 30% staff turnover. Choose the factor s that are real concerns and could impact feasibility. (Select all that apply.)

a. Most of the newly hired nurses are BSNs and newly graduated. b. The new manager grudgingly allows the research to proceed but makes it clear that she will not support subsequent research until the unit is more stable.

c. Fewer patients come to this hospital now for bypass surgery, going instead to its sister hospital across town.

d. Two of the research assistants, who were already trained, take jobs elsewhere. e. Staff nurses dislike the new manager and miss the old one.

ANS: B, C, D

The feasibility of a study is determined by examining the time and money commitment; the researchers expertise; availability of subjects, facility, and equipment; cooperation of others; and the studys ethical considerations. A study might appear feasible but , without the cooper ation of others, it is not. However, most nursing studies involve hum an subjects and are conducted in hospitals, clinics, schools, office s, or homes.

Having the cooperation of people in the rese arch setting, the subjects, and the research assistants involved in data collection is e sse ntial. Pe ople are frequently willing t o cooperate with a study if they view the problem and purpose as significant or if they are personally interested.

DIF: Cognitive Level: Analysis REF: MCS: 84

11. A masters student decide s to conduct a pilot study in order to help with which of the following?

(Select all that apply.)

a. Asse ss working nurse s responses to having a researcher collect data in the middle of their unit.

b. Re-evaluate the actual expenditure of the re searchers time for each subject consented and studied.

c. Allow potential subjects to sample research participation before they fully commit. d. Apply for Human Subjects permission to perform the actual study. e. Determine whether the research side has enough rese arch subjects who are interested in participating in the research.

ANS: A A pilot study is commonly de fined as a sm aller version of a proposed study conducted to refine the methodology. It is developed much like the proposed study, using similar subjects, the same setting, the same treatment, and the same data collection and analysis techniques. As the rese arch pr oblem and purpose increase in clarity and concisene ss, the rese archer has greater direction in determining the feasibility of a study.

The feasibility of a study is determined by examining the time and money commitment; the researchers expertise; availability of subjects, facility, and equipment; cooperation of others; and the studys ethical considerations. The purpose selected for investigation must be ethical, and Human Subjects permission must be obtained be fore even a pilot study is conducted. A pilot study is not used to allow potential subjects to sample

participation before they commit: Human Subjects permission must be obtained before study participation.

Chapter 6. Objectives, Questions, Variables, and Hypotheses MULTIPLE CHOICE

1. Which of the following is the research objective? a. To answer the research question b. To determine the strength of the statistical relationship among the variables c. To determine whether homeless children seem to have longer length of hospital stay, poorer verbal skills, and more fear of separation from their parents than do other children

d. To measure length of stay, verbal skills, and fear of separation from parents in homeless children admitted to the hospital ANS: C Research objective s are clear, concise , declarative st atements that are expressed in the present tense. For clarity, an objective usually focuse s on one or two variable s (or concept s) and indicates whether the variable s are to be identified or de scribed. Objective s can also identify relationships or associations among variables, determine differences between groups or compare groups on selected variables, and predict a dependent variable based on selected independent variables.

DIF: Cognitive Level: Application REF: MCS: 138

2. What is the research question? a. Length of hospit al stay, verbal skills, and fe ar of separation from parents have no relationship to childrens homelessness.

b. Does childrens homelessness affect length of hospital stay, verbal skills, and fe ar of separation from parents?

c. Was homelessness related to length of hospital stay, verbal skills, and fe ar of separation from parents in this study?

d. Is homelessness in children related to length of hospital st ay, verbal skills, and fe ar of separation from parents?

ANS: D A research question is a concise, interrog ative st atement that is worded in the present tense and include s one or more variable s (or concepts). The re search questions focus on (1) the description of the variable(s), (2) a determination of differences between two or more groups regarding selected variables, (3) an examination of relationships am ong variables (relational), and (4) the use of inde pendent variables to predict a dependent variable. In this case ( 3), the examination of relationships among variables, would be the focus of the research question, since cause is not a focus of study.

DIF: Cognitive Level: Application REF: MCS: 140

3. What is the research hypothesis? a. Longer length of hospital st ay, worse verbal skills, and fe ar of separation from parents are caused by childrens homelessness.

b. Homelessne ss in children is related t o length of hospit al st ay, verbal skills, and fear of separation from parents.

c. There is no relationship between childrens homelessness and length of hospit al st ay, verbal skills, and fear of separation from parents.

d. If a child is homele ss, that child is likely to have poor verbal skills, more difficulty separating from parents, and a longer hospital stay.

ANS: B A hypothe sis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. The hypothe sis translates the problem and purpose into a clear explanation or prediction of the expected results or outcomes of the study. A hypothesis (1) specifies the variables the re searcher will m anipulate or measure, (2) identifies the population the researcher will examine, (3) indicates the type of research, and (4) directs the conduct of the study.

Hypothese s are described using the terms in the following four categories: (1) associative versus causal, (2) simple versus complex, (3) directional versus nondirectional, and (4) null versus research.

DIF: Cognitive Level: Application REF: MCS: 142

4. A researcher identifies three variables and formulates a hypothesis that links them. That hypothe sis is testable. What does it mean that the hypothesis is testable?

a. All the variables in the hypothesis are measurable. b. The hypothesis must be replaced by a research question. c. The value of the hypothesis is low. d. The hypothesis is causational.

ANS: A Hypothese s identify different types of relationships and numbers of variables. A well-formulated hypothe sis clearly identifies the relationship between the variable s. A hypothesiss value is ultim ately derived fr om whether it can be te sted in the re al world. A testable hypothe sis is one that contains variables that can be measured or manipulated in the world.

DIF: Cognitive Level: Synthesis REF: MCS: 144

5. A stimulus or activity that is measured to examine the effect created by the indepe ndent variable best describes a(n)

variable.

a. Independent b. Demographic c. Extraneous d. Dependent ANS: D In quantitative re search, the independent variable (intervention, treatment, or experimental variable) is manipulated or varied by the rese archer to cause an effect on the dependent variable. The dependent variable (response or outcome variable) is measured to examine the effect created by the independent variable. An independent variable is a stimulus or activity that is m anipulated or varied by the rese archer to create an effect on the dependent variable. A dependent variable is

the response behavior or outcome that the researcher want s to predict or explain. Extraneous variables exist in all studies and can affect the measurement of study variables and the relationships among them.

Extraneous variables are of primary concern in quantitative studies, because they can obscure ones understanding of the relational or causal dynamics within the studies. Demographic variable s are attributes of the subjects that are measured during the study and used to describe the sample.

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6. The intervention that the researcher manipulates is the

variable.

a. Independent b. Demographic c. Extraneous d. Dependent ANS: A In quantitative research, the independent variable (intervention, treatm ent, or experimental variable) is manipulated or varied by the researcher to cause an effect on the dependent variable. The dependent variable(response or outcome variable) is measured to examine the effect created by the inde pendent variable.

An independent variable is a stimulus or activity that is m anipulated or varied by the re searcher to create an effect on the dependent variable. A dependent variable is the response behavior or outcome that the researcher want s to predict or explain. Extraneous variable s exist in all studie s and can affect the measurement of study variables and the relationships am ong them. Extraneous variable s are of primary concern in quantitative studies, because they can obscure one s understanding of the relational or causal dynamics within the studie s. The extraneous variables that are not recognized until the study is in process or are recognized before the study is initiated but cannot be controlled are referred to as confounding variables.

Demographic variables are attributes of the subjects that are measured during the study and use d to describe the sample.

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7. It is important for the researcher to identify extraneous variables so that

a. All of the extraneous variables can be manipulated by the researcher. b. The findings can be explained as clearly and truthfully as possible. c. The research results are not critiqued unfairly. d. The extraneous variables have no influence on the dependent variable.

ANS: B Extraneous variable s exist in all studies and can affect the measurement of study variables and the relationships among them. Extraneous variables are of primary concern in quantitative studies, because they can obscure one s under standing of the relational or causal dynamics within the studies. Extraneous variables are classifie d as (1) recognized or unrecognized and (2) controlled or uncontrolle d. The extraneous variables that are not recognized until the study is in process or are recognized before the study is initiated but cannot be controlled are referred to as confounding variables. Sometimes these variables can be measured during the study and controlled statistically during analysis. In other cases, it is not possible to measure a confounding variable, and the variable thus hinders the interpretation of findings. Such extraneous variable s must be identified as limitations or areas of study weakness in the discussion section of a research report.

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8. Simple descriptive statistics may be used to depict the sample characteristics, reflecting demographic variable values, in which kind of research?

a. Quantitative research only b. Qualitative research only c. Both quantitative and qualitative research d. Only when data has been extracted from an electronic database ANS: C Demographic variables are attributes of the subjects that are me asured during the study and used t o de scribe the sample. Demographic variables are presented as the sample characteristics, using

simple de scriptive statistics such as frequency and percentage, in both quantitative and qualitative research.

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9. In the following hypothesis, what is the independent variable?

Patients with recurrent bowel obstruction due to Crohns disease who are assigned to be treated in an emergency room com plain less frequently of pain and require less pain me dication than those patients admitted, in the usual fashion, and treated on a medical floor.

a. Bowel obstruction due to Crohns disease b. Place treated c. Number of complaints of pain d. Number of doses of pain medication ANS: B An independent variable is a stimulus or activity that is manipulated or varied by the rese archer to create an effect on the dependent variable. The independent variable is also calle d an intervention, treatment, or experimental variable. In this example, place treated (emergency room versus medical floor) is the independent variable.

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10. In the following purpose statement, what kind of variable is number of days absent from class?

The purpose of this study was to examine the effects of a generous weekly allowance and twice - weekly text messages from parents on number of days absent from class, in freshman college students.

a. Demographic variable b. Independent variable c. Extraneous variable

d. Dependent variable ANS: D A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain. In this example, num ber of days absent from class is the dependent variable. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable.

Demographic variables are attributes of the subjects that are measured during the study and used to describe the sample . Extraneous variable s exist in all studie s and can affect the me asurement of study variables and the relationships among them.

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11. The following statement is an example of which of the following?

There is no measurable difference in incidence of incarceration for adolescent children whose mothers work outside the home in comparison with those whose mothers do not work outside thehome.

a. Null hypothesis b. Confounding variable c. Research objective d. Research question ANS: A A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. The null hypothesis, also referred to as a statistical hypothesis, is use d for statistical testing and interpretation of st atistical outcomes. The null hypothesis can be simple or complex and associative or causal. The null hypothe sis states that there is no relationship between two or more variables. Extraneousvariable s exist in all studies and can affect the measurement of study variable s and the relationships am ong them. The extraneous variables that are not recognized until the study is in process, or that are recognized

before the study is initiated but cannot be controlle d, are referred to as confounding variables. Research objectives are clear, concise, declarative statements that are expressed in the present tense, focus on one or two variables (or concept s), and indicate whether the variable s are to be identified or described. A research question is a concise, interrogative statement that is worded in the present tense and includes one or more variables (or concepts).

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12. In the following hypothesis, what is the dependent variable?

There is no measur able difference in incidence of acne in 15 -year-olds who are placed on a chocolate-free diet.

a. Fifteen-year-olds b. No chocolate in the diet c. Chocolate in the diet d. Acne ANS: D A dependent variable is the re sponse behavior or outcome that the rese archer want s to predict or explain. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. In this example, acne is the dependent variable and removal of chocolate from the diet is the independent variable.

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13. What is the relationship between a conceptual definition and an operational definition? a. The conceptual definition provides information; the operational definition provides none.

b. The conceptual definition is concrete, and the operational definition is abstract. c. They are the same, in most instances. d. The operational definition allows the researcher to create a measurable variable from a concept; the conceptual definition does not.

ANS: D Operationalizing a variable or a concept involve s developing conceptual and operational de finitions. A conceptual definition provides the theoretical meaning of a concept or variable . The conceptual definition provide s a basis for formulating an operational de finition. An operational definition is derived from a set of procedures and progressive acts that a rese archer performs either to manipulate an independe nt variable or to measure the existence or degree of existence of the dependent variable.

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14. In the following research question, what is the independent variable?

Can diabetics on oral antiglycemic medications achieve better control of blood sugar, as me asured by Hgb A1C, if they are taught to meditate and do this on a daily basis?

a. Oral antiglycemic medications b. Hgb A1C c. Meditation d. Blood sugar ANS: C An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the de pendent variable. The indepe ndent variable is also calle d an intervention, treatment, or experimental variable. In this example, nausea and vomiting are dependent variables and guide d imagery and relaxation techniques are independent variables.

DIF: Cognitive Level: Application REF: MCS: 145 MULTIPLE RESPONSE

1. Which of the following are the research variables in this study? (Select all that apply.) a. Patient age

b. Verbal skills c. Homelessness d. Parental presence e. Fear of separation from parents f. Whether or not a child is homeless g. Length of hospital stay ANS: B, E, G Research variables or concepts are the qualities, properties, or characteristics that are measured in qualitative studie s and selected quantitative studies. Concrete conce pts, such as temperature, weight, and blood pressure, are referred to as variables in a study; abstract concept s, such as cre ativity, empathy, and social support, are sometimes referred to as research concepts.

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2. Which of the following could be a dependent variable in an experimental study? (Select all that apply.) a. Medication A b. The number of times the gerbil rings the bell c. Quality of life d. The number of times the subject is instructed in how to use the experimental equipment

e. Vomiting ANS: B, C, E A dependent variable is the response behavior, or outcome that the researcher want s to predict or explain. An independent variable is a stimulus or activity that is manipulated or varied by the re searcher to create an effect on the dependent variable.

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3. Which of the following could be an independent variable in an experimental study? (Select allthat apply.) a. Quality of life b. The percentage of moisture in the inspired air the subject breathes c. The researchers preference for quantitative versus qualitative methodologies d. Wearing a hat with a large brim e. Seizure activity during the experiment ANS: B, D An independent variable is a stimulus or activity that is m anipulated or varied by the rese archer to create an effect on the depende nt variable. The independent variable is also called an intervention, treatment, or experimental variable . A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain.

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4. Which of the following are operational definitions? (Select all that apply.) a. Length of smoking cessation is the subjects st atement of how long it has been since the subject last smoked tobacco.

b. Pain is whatever the patient says it is, whenever the patient says it is (Margo McCaffrey).

c. Imagination is the ability to see what will be, not what is. d. Startle is the dist ance the rese arch subject move s whe n a puppet tarantula is dr oppe d into his field of view, in front of a computer screen.

e. Nause a is the number the subject provide s, on a 0- t o 10-point numerical scale, in response to being asked how nauseated the subject is.

ANS: A, D, E An operational definition is derived from a set of pr ocedures and progre ssive acts that a researcher performs either to manipulate an inde pendent variable or to measure the existence or degree of existence of the dependent variable.

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5. Which of the following could be a research question? (Select all that apply.) a. What does postoperative vomiting feel like, to research subjects? b. How is hypnosis related to smoking cessation? c. In an English cour se, how do grading, praise, practice, submitting papers for publication, and writing skills interact?

d. What are the differences between clients with pre-op orientation and those without, in terms of procedural anxiety?

e. How does the researcher define loneliness?

ANS: A, B, C, D Research questions meet the following criteria: (1) the identification and/or description of the variable(s), (2) a determination of differences between two or more groups regarding selected variables, ( 3) an examination of relationships among variables (relational), and (4) the use of independent variable s to predict a dependent variable.

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6. Martha wants to know what happens when she fries bacon in a frying pan, versus microwaving it: does the bacon end up moister and more flavorful when fried, or when microwaved? What are the dependent variables? (Select all that apply.)

a. Frying bacon b. Microwaving bacon c. Consistent cooking temperature d. Variable cooking temperature e. Moistness of bacon f. Kitchen burns g. Flavor of bacon ANS: E, G

A dependent variable is the response behavior, or outcome that the researcher want s to predict or explain. An independent variable is a stimulus or activity that is m anipulated or varied by the rese archer to create an effect on the depende nt variable. In this example, whether the bacon ends up m oister and m ore flavor ful is the dependent variable and method of cooking is the independent variable.

DIF: Cognitive Level: Application REF: MCS: 145

7. Ralph is an experimental psychologist. He studie s rat behavior. He runs r ats through a maze , under different scent conditions. At the end of the maze is cheese . Sometimes the m aze is lit, and sometimes it is dark. During each run, the rates are subjected to different scents (cat pheromone , the smell of cheddar cheese, tiger pheromone, the smell of rat feces) at crucial decision-point s in the maze. Ralph measures the time it takes the rats to finish the maze. Which of the following could be considered independent variable s in this study? (Select all that apply.)

a. The rats b. Light versus dark c. Ralph d. The amount of time the rats take to finish the maze e. The scents f. The cheese at the end of the maze g. Rat behavior ANS: B, E An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the de pendent variable. The indepe ndent variable is also calle d an intervention, treatment, or experimental variable. In this example, how long in seconds it takes the rats to run through the maze is the dependent variables and different scents are inde pendent variables; light ver sus dar k are the two experimental conditions, and these could also affect the outcome, so they could also be considered independent variables.

DIF: Cognitive Level: Application REF: MCS: 145

8. What type of hypothesis is the following? (Select all that apply.)

Increased intake of dietary fiber in elders and increased fluid intake are associated with fewer episodes of diverticulitis?

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, D, F A hypothesis is a formal st atement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship ( associative or causal) between two variable s. A complex hypothesis predict s the relationship ( associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

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9. What type of hypothesis is the following? (Select all that apply.)

Taking lessons to learn how to play bridge, and weekly practice in playing bridge, have an effect on beginning bridge players win-loss ratio.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis

d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, C, E A hypothesis is a formal st atement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship ( associative or causal) between two variable s. A complex hypothesis predict s the relationship ( associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142

10. What type of hypothesis is the following? (Select all that apply.)

Having one s house and yard professionally sprayed ye arly by an extermination service has an effect on infestations of common garden ants.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, C, E A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship

(associative or causal) between two variables. A complex hypothesis predict s the relationship (associative or causal) among three or more variables. The relationships identified in hypothe ses are associative or causal. An associative relationship identifies variable s that occur or exist together in the real world. Causal relationships identify a cause-and-e ffect interaction between two or more variables. A nondirectional hypothesis state s that a relationship exists but doe s not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142

11. What type of hypothesis is the following? (Select all that apply.)

Providing early written feedback to undergraduate nursing students in the clinical setting increase s the incidence of desired behavior s of safe medication administration, work efficiency, accurate charting, and competent time management.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, C, F A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variable s. A complex hypothesis predicts the relationship (associative or causal) am ong three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause -and-effect interaction between two or more variable s. A nondirectional hypothesis state s that a relationship exist s but does not predict the nature of the relationship. A directional hypothesis st ates the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142

12. What type of hypothesis is the following? (Select all that apply.)

Number of hour s spent daily playing video game s is negatively related to student achievement in high school history class.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, D, F A hypothesis is a formal st atement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship ( associative or causal) between two variable s. A complex hypothesis predict s the relationship ( associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142

13. What type of hypothesis is the following? (Select all that apply.)

The number of children in the home is associated with noise level in that home, and with parental stress.

a. Simple hypothesis

b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, D, E A hypothesis is a formal st atement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship ( associative or causal) between two variable s. A complex hypothesis predict s the relationship ( associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

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14. What type of hypothesis is the following? (Select all that apply.)

The number of minutes a 16-year-old girl spends applying her makeup in the morning is related to her perceived personal attractiveness.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional ANS: A, D, E

hypothesis

A hypothesis is a formal st atement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship ( associative or causal) between two variable s. A complex hypothesis predict s the relationship ( associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142

15. What type of hypothesis is the following? (Select all that apply.)

Decreasing the time allotted for weekly in-class pop quizzes incre ase s student anxiety and decreases student grades.

a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, C, F A hypothe sis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypothese s are associative or causal. An associative relationship identifies variable s that occur or exist together in the real world. Causal relationships identify a cause-andeffect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not

predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

ANS: B Feedback AUnlike variables in a quantitative study, they usually are not easily measured.

BIn many qualitative studies, the focus of the study is to define or describe the concept.

CThey are developed as the study unfolds and do not have to be clearly de scribed in order to pr oceed with the study.

DThey are developed as the study unfolds and do not have to be cle arly describe d in order to proceed with the study.

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34. Which type of variable is used in a summary of sample characteristics? a.Dem ographic variables b.De pendent variables c.Independent variables d.Research variables ANS: A Feedback A Demographic variables are attributes of subjects that are collected to describe the sample.

B Dependent variables are variables that change as a result of manipulation of the independent variable.

C Independent variables are variables that are manipulated to observe effects on dependent variables.

D Re search variable s are variables use d in qualitative studies.

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35. Which is true about a statement of the research purpose? a. It describes the background for the subject of the research study. b. It includes a discussion of the significance of the study. c. It includes the research problem statement. d. It provides a concise description of the studys focus.

ANS: D Feedback A The review of the literature provides background for the subject of a research study.

B The studys significance is a part of the overall purpose of the study.

C The research problem statement is a separate statement and includes a discussion of the studys significance.

D The research purpose is a concise, cle ar statement of the specific goal of focus of the study. PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 158

36. An examination of the rese archers plan for using measurement tools to examine relationships among variables helps determine the: a.research hypothesis. b.research objectives. c.study feasibility. d.study purpose.

ANS: A Feedback A The research hypothe sis is determined through the research question and is a statement about the relationship among the research variables.

B The research objectives are identified in the research purpose.

C The study fe asibility is determined by the rese archers expertise, the available funding, measurement tools and sample population availability, and ethical considerations.

D The study purpose is a statement identifying what will be measured in a particular study. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 158

37. Which is true about a research hypothesis? a. It defines the various research variables and describes how they will be measured. b. It explains the relationship of the research purpose to theory development. c. It includes the research problem, purpose, and research questions. d. It links the research problem statement to the study design and data analysis.

ANS: D Feedback AThe problem statement can link the research purpose to theory development.

BThe introduction contains the research problem, purpose, and research questions.

CThe research purpose links the problem statement to the study design and data analysis.

DThe research hypothe sis is the formal statement of the expected relationship between two or more variables in a specified population.

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38. In a research proposal, a statement about expected relationships among variables is the: a.conceptual de finition. b.operational definition. c.research hypothe sis. d.research problem.

ANS: C Feedback A The conceptual definition is derived from the theoretical definition of a related concept and provides theoretical meaning for a variable.

B An operational definition is derived from a set of procedures or progressive act s that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable.

C The research hypothe sis is the formal statement of the expected relationship between two or more variables in a specified population.

D The research problem identifies gaps in knowledge.

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39. Which type of variable is manipulated by the researcher? a.Dem ographic b.De pendent c.Independent d.Research ANS: C Feedback A Demographic variables are attributes of members of a sample population.

B The dependent variable is the outcome variable and is the variable researcher s wish to predict based on manipulation of the independent variable.

C The independent, or experimental variable, is m anipulated by the rese archer in order to observe possible effects on the dependent variable.

D A research variable is used in qualitative studies.

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40. In a study of adolesce nt children using a group of high school football players and junior - high school cyclists, researchers compared the length of recovery from concussion between those wearing brand X helmets and those we aring brand Y helmets. In this study high school football players represent which type of variable? a.Dem ographic b.De pendent c.Independent d.Research ANS: A Feedback ADemographic variables are attributes of members of a sample population.

BThe dependent variable is the outcome variable and is the variable researchers wish to predict based on manipulation of the independent variable.

CThe independent , or experimental variable, is manipulated by the researcher in order to observe possible effects on the dependent variable.

DA research variable is used in qualitative studies.

Chapter 7. Review of Relevant Literature

MULTIPLE CHOICE

1. One reason for conducting a review of the literature other than for purposes of developing a research study is to: a.determine the expertise of researchers in the field of study. b.identify current theoretical frameworks. c.implement evidence-based practice guideline s. d.wor k in a Magnet-certified hospital setting.

ANS: C Feedback AEvaluation of the expertise of researchers and identification of theoretical framewor ks are part of literature reviews but are not the reason for conducting them.

BEvaluation of the expertise of rese archers and identification of theoretical framewor ks are part of literature reviews but are not the reason for conducting them.

CAlthough a literature reviews are commonly associated with development of rese arch studies, they are also conducted when developing projects to establish evidence-based-practice (EBP).

DNurses in Magnet hospitals often participate in EBP projects and will conduct literature reviews for these, but not solely to be able to work in these institutions.

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2. What is the purpose of a limited research review? a.To allow the reader to become familiar with the research problem b.To develop an initial pilot study prior to a more in-depth study c.To direct the planning and execution of a study d.To identify studies published after a study is performed ANS: D Feedback AA full literature review allows the reader to become familiar with the research problem and is performed prior to a pilot or a full study.

BThe full literature review directs the planning and execution of the study.

CThe full literature review directs the planning and execution of the study.

DA limited research review is often conducted after an initial literature review in order to de scribe any studies performed after the study has been performed. The results of both the original literature review and the limited literature review are included in the report.

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3. A reviewer reading a proposal for a qualit ative research study note s that the author has not included a literature review. The reviewer underst ands that a literature review may have been omitted in this case because:

a. it is not necessary to conduct a literature review for qualitative research. b.qualitative rese arch is conducted to study areas where there is no previous knowledge. c.some researchers feel that previous studies may bias dat a collection in qualit ative studies. d.the researcher was not adequately prepared to conduct this research study.

ANS: C Feedback AA literature review can be helpful in qualitative research and should be performed if possible.

BThis is true of some but not all qualit ative methods (for example grounde d theory); howe ver, it is not true of all qualitative designs.

CMany times literature reviews are omitted from qualitative research to avoid causing expectations that might bias findings, data collection, and data analysis.

DAt times, there is little or no previous research on the topic, but not always.

Omission of a literature review in qualitative research does not indicate that the researcher isill-prepared.

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4. Which type of study is least likely to include a review of the literature prior to initiating the study? a.Grounded the ory b.Phenomenological c.Qualit ative d.Quantitative ANS: B Feedback

AGrounded theory researcher s may have a limited review of relevant studies in order to make the researcher aware of what studies have been conducted and that a research problem exists.

BPhenomenological rese archers are m ost likely to delay literature review until after a study is com pleted in order to avoid bias.

CQualit ative and quantitative research will involve literature reviews, although these may be less substantial in qualitative studies.

DQualitative and quantitative rese arch will involve literature reviews, although the se may be less substantial in qualitative studies.

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5. What is the main purpose of a literature review in grounded theory research? a.To explain, extend, and support the framework used for the study b.To identify gaps in current knowledge about the research topic c.To place research findings in context of what is already known. d.To support the need to study the selected research topic ANS: A Feedback AIn grounded the ory research, the rese archer uses the literature review primarily to explain, support, and extend the framework used in the study, and not to direct data collection or study methods. It is usually com pleted at the end of the analysis rather than before the proposal development BThe literature review in quantitative studies is designed to identify gaps in knowledge.

CPhenomenological literature reviews are conducted to place research findings in the context of what is already known.

DBecause the literature review for grounded the ory research is generally conducted at the end of the analysis, it is not used to support the need for studying the topic, but to summarize what is known.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 164

6. Why might Wikipedia be a questionable reference for a study citation? a. It does not contain factual information. b. It does not provide ideas for other resources. c. It is an online resource.. d. It is an open, editable format.

ANS: D Feedback AWikipedia may contain factual information, but this is not reliable.

BWikipedia may provide ideas for other resources.

CWikipedia is an online resource, but that fact does not exclude it from being used.

DWikipedia is an ope n, editable form at; the inform ation may not always be accur ate because it is not peer reviewed and scientifically based.

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7. Which source of information is rarely cited in academic publications? a.Conference pr oceedings b.Dissertation or thesis c.Encyclopedia d.Textbooks ANS: C Feedback A Conference proceedings, dissertations or theses, and textbooks may all be cited.

B Conference proceedings, dissertations or theses, and textbooks may all be cited.

C Encyclopedias tend to provide background information and some inform ation leading to other resources, but generally not scholarly or primary source information.

D Conference pr oceedings, dissertations or the ses, and textbooks may all be cited. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166

8. When determining the reliability of a website resource in a literature review, it is important to determine: a.accessibility of the website information. b.costs of retrieving website information. c.sponsorship of website information. d.whether website information is also published conventionally. ANS: C

Feedback AAccessibility, cost, and conventional publication of website inform ation are not determinant s of reliability of website information.

BAccessibility, cost, and conventional publication of website inform ation are not determinant s of reliability of website information.

CNot all websites are valid and appr opriate for citation in a literature review. Those that are sponsored by companies that sell certain pr oducts under study may not be appropriate resources because their information may be biased.

DAccessibility, cost, and conventional publication of we bsite information are not determinant s of reliability of website information.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166

9. A review of empirical literature will yield information obtained from: a.concept analyses. b.de scriptions of m odels and framewor ks. c.research studies. d.theories.

ANS: C Feedback A Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

B Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

C Empirical literature refers to knowledge derived from research and is based on data from research.

D Theoretical literature includes concept analyses, models, theories, and conceptual fr ameworks. PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 166

10. What is an important limitation of secondary sources in literature reviews? a.The authors do not have high levels of expertise. b.They are usually not peer-reviewed sources. c.They do not contain unique or original information. d.They may cont ain misinterpreted information.

ANS: D

Feedback AAuthors of secondary sources have similar levels of expertise as those of primary sources.

BSecondary sources may cont ain original information as authors synthesize and analyze findings from primary sources.

CSecondary sources are usually peer reviewed.

DA secondary source summ arizes or quote s content from primary source s. Because authors of secondary sources paraphrase the wor ks of researchers and theorists and interpret what the primary author wrote, this information may be misinterpreted.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166

11. When reviewing articles in a peer-reviewed publication, the reader is assured that the articles are: a.landm ark studies. b.primary sources. c.seminal studies. d.trustworthy sources.

ANS: D Feedback ALandm ark studie s, primary sources, and seminal studies are included in peer -reviewed literature, but may also appear in literature that is not peer reviewed.

BLandmark studies, primary sources, and seminal studie s are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed.

CLandmar k studie s, primary sources, and seminal studie s are included in peer -reviewed literature, but may also appear in literature that is not peer reviewed.

DRese arch reports det ailing study event s, including result s and analysis of findings included in refereed profe ssional journals, are considered one of the most credible types of evidence and are typically considered one of the most useful source s for researchers as they conduct a literature review for a current study. Articles found in refereed journals have been evaluated in an anonymous proce ss by unbiased reviewers and received favor able review, not only for the integrity of the research it self, but because the topic of interest has been deemed significant to the profession.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 166

12. For a study to be considered current, it should be published within the last:

a.year. b.2 years. c.5 years. d.10 years.

ANS: C Feedback A This is not a correct statement.

B This is not a correct statement.

C Current sources are those published within 5 years before publication of the manuscript.

D This is not a correct statement.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 166

13. Some studies cited in a literature review may be decades old. The researcher may decide to use studies from this far back because these studies: a.are groundbreaking or landm ark studie s. b.are particularly well-written studies. c.are peerreviewed, relevant studies. d.are still considered current studies.

ANS: A Feedback AStudies that are groundbreaking or landm ark studie s are those that were significant to the development of knowle dge on the t opic being reviewe d. In this case, it is appr opriate to cite these studies, even if they are very old.

BWell-written, peer reviewed studies that are not current are generally not used in a literature review.

CWell-written, peer reviewed studies that are not current are generally not used in a literature review.

DStudies that are decades old, howe ver well-written and relevant, are not current studies, but are used for historical or seminal context.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166

14. A researcher conduct s a study using de pendent and inde pendent variable s use d in a previous study but uses a different population of subjects. What type of study is this? a.Landmark b.Pilot c.Replication d.Seminal ANS: C Feedback AA landm ark study is one that generates knowledge that influences a discipline and sometimes society as a whole. Landmark studies are often replicated.

BA pilot study is a study using a sm all sample size to de velop the study methods and tools and is later replicated on a larger scale.

CA replication study is a reproduction or repetition of a study that a researcher conducts to determine whether the findings of the original study can be consistently found in different settings with different subjects.

DA seminal study is the first study on a particular topic that signals a new way of thinking about the topic.

These studies are often replicated.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166

15. A nurse appr aising a re search article should perform which action in order to critically e valuate the literature review? a.Locate and review sources and abstracts listed in the research article b.Note the num ber of data-based and theoretical sources cited in the reference list c.Perform a meta-analysis or meta-synthesis on the cited references d.Search the literature to determine whether other relevant sources exist ANS: B Feedback ALocating and reviewing all abstract s would be too time consuming and may not be possible. BBecause it would be very time consuming to search the literature and determine whether the listed sources are relevant, the reviewer should review the reference list and determine the focus of the source s, the number of data-based and theoretical sources cited, and where and when the sources were published.

CMeta-analysis and meta-synthe sis are not done when critically appr aising a literature review. These techniques are used to perform an in-depth analysis of studies already cited in the literature.

DIt is not necessary at this point to search the literature to determine other relevant sources.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 168-169

16. When appraising a literature review, one aspect of determining the breadth of the review is: a.whether the review provides direction for the proposed study. b.the number and percentages of sources from the past 5 to 10 year s. c.whether landmark or seminal studies have been used. d.the disciplines of the study authors and journals cited in the review.

ANS: D Feedback AAn assessment of whether the literature review provide s direction for the study does not specifically evaluate the breadth of the literature review.

BThe currency of the literature review is evaluated by noting the num ber of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited.

CThe currency of the literature review is evaluated by noting the number of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited.

DWhen asse ssing the breadth of a literature review, the reviewer should identify the discipline s of the authors cited and the journals in which they published their studies.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

168-169

17. An initial step when preparing to conduct a literature review is to: a.choose the types of source s to use. b.clarify the purpose of the review. c.determine how many articles to review. d.select electronic data bases and keywords.

ANS: B Feedback AThe types of sources and the number of articles to review depend on the purpose of the review.

BBecause the approach will vary according to the purpose of the review, the first step in conducting a literature review is to identify the purpose of the review.

COnce the purpose of the review is established and the author has an ide a about the type and number of sources, the electronic databases and keywords are selected.

DOnce the purpose of the review is established and the author has an idea about the type and number of sources, the electronic databases and keywords are selected.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176

18. When conducting a literature review for a the sis or dissertation and deciding how far back in the available literature to search, what will the student do? a.Ask the instructor to specify necessary publication year s for articles cited. b.Base the decision on the number of articles necessary for the assigned task. c.Locate any seminal or landmark studies on the topic of research. d.Look for sources no older than 10 years prior.

ANS: C Feedback AThe breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

BThe breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

CWhen beginning a thesis or dissertation, the graduate student should look for seminal or landm ark studies as a place to begin a literature review.

DThe breadth and currency of the literature review should be base d on the topic and the purpose of the research and not on an assigned number or a particular number of years.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176

19. When developing evidence -based-practice guideline s, if a rese archer wishe s to identify studie s that evaluate a specific intervention in quantitative research, the literature review should include: a.grounded theory research. b.only current research from the last 5 year s. c.replication studies and meta-analyses.

d. seminal and landmark studies about the topic.

ANS: C Feedback A Grounded theory research is performed to test theory.

B While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review.

C To synthesize evidence related to a practice problem and to evaluate a specific intervention in quantitative research, replication studies, meta-analyses, and meta-syntheses are used.

D While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: MCS: 176

20. In the following APA-formatted reference, what is indicated by the italicized words?

Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparison perspective (2nd ed.). Mahway, NJ: Lawrence Erlbaum Associates. a.Abstract information b.Article title c.Book title d.Publishing company ANS: C Feedback A The abstract information is not included in a reference citation.

B An article title is italicized if the citation is from a journal.

C When citing a book, the title is italicized.

D The publishing company information is listed last .

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS : 184

21. A step just prior to beginning a literature search using an electronic database is to: a. decide how many articles are needed.

b.determine the type of study. c.identify keywords for the search. d.perform a Google search.

ANS: C Feedback AThe number of articles needed for a literature review depends on the content of the articles and will not be known ahead of time.

BThe study type is not typically determined just prior to an electronic search.

CTo narrow the number of articles in a search and refine the search to more relevant articles, identifying keywords is necessary.

DA Google se arch may or may not be helpful for leading a researcher to other articles, but it is not a scientific database.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176

22. When conducting a literature search, which electronic product would a nur se researcher use to track and store reference information? a.Cumulative Index of Nur sing and Health Literature (CINAHL) b.EndNote s or Ref Works c.Google Scholar d.Science Direct ANS: B Feedback A CINAHL is an electronic database used to search literature.

B EndNotes is reference management software that helps to track and store information on all search fields and allows the researcher to file this information with comments about each reference.

C Google Scholar is an electronic search engine.

D Science Direct is an electronic search engine.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS : 178

23. After a literature search has yielded a list of articles, an efficient way t o identify relevant studies during a literature search is to review: a.an electronic database se arch history. b.only experimental studie s. c.reference lists in other studies. d.study abstracts.

ANS: D Feedback AThe electronic database se arch history lists only articles searched for but doe s not yield information about whether or not they are relevant.

BExperimental studies are not always relevant to a particular study, and other types of studies m ay be relevant.

CReference lists in other studies may give information about other articles t o review, but do not give information about the content of these articles.

DThe abstract provides pertinent information about the article in a condense d, easy to peruse format so that the researcher can determine whether the article is pertinent to the topic.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 179

24. Once relevant studies have been identified, the researchers next step is to: a.determine the expertise of each studys authors. b.obtain full-text copies of each of these articles. c.review the study design and methodology of each article. d.write the literature review based on abstract information.

ANS: B Feedback ADuring the literature review, the researcher will examine the authors expertise and will review the study design and methodology.

BAlthough the abstract information helps to determine a studys relevance, it is e ssential to read the full-text article to conduct a literature review. Once relevant studie s are found, the researcher must obt ain either electronic or print full-text articles.

CDuring the literature review, the researcher will examine the authors expertise and will review the study design and methodology.

DThe literature review cannot be written based on abstract information only.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

179-180

25. When initially reading the relevant literature for comprehension, the researcher will: a.critically appraise the studies. b.highlight the main points of the studies. c.make decisions about paraphrasing quotes. d.review the abstract only.

ANS: B Feedback ACritical appraisal involves making value judgments about the validity or credibility of the study content.

BComprehending a source begins by reading and focusing on understanding the m ain point s of the article and can be achieved by highlighting the main points of the article.

CDeciding what to paraphrase occurs later, just before writing the review.

DReviewing the abstract helps the researcher determine which articles are relevant but does not help with comprehension.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

180-181

26. A researcher perform s a critical appr aisal of a gr oup of studies me asuring the effects of a home care education program on confidence levels of caregivers of elderly family members. The critical appraisal will include: a.determining the theoretical frameworks use d for defining confidence. b.identifying sam pling and inclusion criteria used in the studie s. c.making value judgments about the credibility and validity of concept s. d.recording quotations relevant to the concept of confidence.

ANS: C Feedback AWhile identifying theoretical fr ameworks, identifying sampling technique s and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

BWhile identifying the oretical frameworks, identifying sampling technique s and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

CTo critically appr aise an article, relevant content is identified and value judgment s are made about the validity and credibility of key concepts.

DWhile identifying theoretical framewor ks, identifying sampling technique s and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

180-181

27. To analyze a body of literature in a literature review the reviewer will: a.de scribe the findings of e ach study in the literature review. b.list the studies and itemize the findings of each one . c.make value judgments about the credibility of e ach study. d.synthe size and summarize findings from various studies.

ANS: D Feedback AIt is not enough to merely describe the findings or to list the information in each one. BIt is not enough to merely describe the findings or to list the information in each one. CMaking value judgments is part of the appraisal process.

DAnalysis requires synthesis and summarization of findings of the studies listed and an ability to m anipulate the information by the reviewer.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

180-181

28. Which is most important in a critical appraisal of a body of literature? a.Counting the available resources to determine whether more information is necessary. b.Examining the quality and content of the resources to determine the credibility and validity of each. c.Reviewing the reference lists in each study to find other relevant studies and landmark studies. d.Searching the literature thoroughly using appropriate keywords to ensure that all relevant literature is included.

ANS: B

Feedback AThe literature search is important and must be thorough, but the critical appraisal depends on an evaluation of the quality and not the quantity of the available resources.

BCritiquing the literature review of a published study involves examining the quality of the content and sources presented. This is more important than achieving an accurate count of available resources.

CReviewing the reference list s may be useful for determining whether other relevant studie s exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available.

DSearching the literature thoroughly using appropriate keywor ds to ensure that all relevant literature is included. may be useful for determining whether other relevant studie s exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

180-181

29. In a literature review, the author identifies themes present in articles under review and de scribes connections among these themes. This is an example of: a.analysis. b.appraisal. c.synthe sis. d.theorizing.

ANS: C Feedback AAnalysis requires manipulation of what is found, literally making it the authors own.

BAppraisal involve s identifying relevant content and determining the credibility or validity of the information.

CSynthesis of sources involves thinking deeply about what has been found and identifying the main theme s of the information.

DTheorizing is part of developing the research question.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 180-182

30. A researcher reviews sever al articles about coping skills am ong parents of children with chronic illness and notes that half of the studies involved single-parent families. The researcher

decides to examine whether coping skills differ in single-parent versus dual-parent households. The researcher is engaging in: a.analyzing. b.appraising. c.evaluating. d.synthesizing.

ANS: D Feedback AAnalysis requires manipulation of what is found, literally making it the authors own.

BAppraisal involve s identifying relevant content and determining the credibility or validity of the information.

CEvaluation involves reviewing the literature content and determining its relevance to the topic.

DSynthesis of sources involve s thinking deeply about what has been found and identifying the main themes of the information. In this case, the reviewer has discovered a variable that may affect the outcome of the studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp.

182-183

31. When developing the outline for a literature review, the researchers first step is to: a.de scribe the focus or pur pose of the review in the discussion section. b.include a statement about what is known in the literature. c.make notes about which sources to site in each section. d.use a standardized format to outline subsections in the discussion section.

ANS: C Feedback AThe introduction section includes the focus or purpose of the literature review.

BThe conclusion contains the statement about what is known in the literature.

CAn initial outline is the first step in writing the literature review and begins with determining the major sections for the paper and identifying the sources that will be used in each one.

DThe discussion section format will vary based on the topic.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 183-184

32. The concluding sentence of each paragraph in a literature review: a.de scribes relevant studies that support the theme of the paragraph. b.identifies the main themes of the paragraph. c.provides evidence to support the topic of the paragr aph. d.transitions to the ideas expressed in the following paragraph.

ANS: D Feedback AThe opening sentence identifies the main themes of the paragraph.

BThe sentences between the opening sentence and the concluding sentence describe relevant studie s and provide evidence to support the paragraph topic.

CThe sentences between the opening se ntence and the concluding sentence describe relevant studie s and provide evidence to support the paragraph topic.

DThe concluding sentence in a paragraph in the literature review should transition t o the ideas expressed in the following paragraph.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

183-184

33. When citing sources in a literature review, it is best if the author: a.paraphrases other authors ideas. b.points out any de fects in other author s work. c.synthe sizes the work of a group of authors. d.use s direct quotations as much as possible.

ANS: A Feedback AWhen citing the work of other authors, the author of a literature review should par aphrase their words whenever possibleclearly, and in the reviewers own words.

BIt is important, in an analysis of the literature, to identify defects in other authors wor ks, but this should be done with respect and without being highly critical.

CSynthesis of others work is an im portant part of the literature review as well and involves par aphr asing and analysis.

DDirect quotations should be avoided unle ss the author states something in a unique way. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 183-184

34. An author use s an electronic source in portable document format (PDF). Which is true about citing this source in a literature review?

a. It is necessary to provide the URL used to retrieve the article electronically. b. It is not treated differently than a print version of the article. c.The original print article must be located. d. TheMCS: numbers will not be available for citation.

ANS: B Feedback A Pe rU ovRiLdifnogr tshuch an article is not helpful in this case.

B When retrieving a PDF document, the source is cited as if a copy of the print version of the article had been used.

C It is not necessary to locate the original print article when a PDF article is used.

D A PDF article is the same as a print article and will haveMCS: numbers for citation.

Chapter 8. Frameworks MULTIPLE CHOICE

1. Which is true about a study framewor k? a.It guides nurses in clinical practice. b. It explains a portion of a theory. c. It is one of the major ideas of a theory. d. It is the underlying methodology used in research.

ANS: B Feedback AThe knowledge gained from testing theories is used to guide nursing practice.

BA study framework is a brief explanation of a theory or those portions of a theory that are to be tested in a study.

CConcepts are the major ideas contained in a theory.

DThe framework is not the methodology, which consist s of sampling techniques, tools, and measures used to gather and analyze data.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 190

2. Which statement is true about theory and qualitative studies? a.Qualitative studies rely on conceptual fr ameworks and not on theory. b.Qualitative studies are not based on theory. c.Qualitative studies may be used to create theory. d.Qualitative studies use theory in the same way as quantitative studies.

ANS: C Feedback AQualitative studies do not rely on conceptual frameworks.

BQualitative studies may be based on theory.

CQualitative studies may be based on a theory or may be designed to create a theory.

DQuantitative studies are designed to test the com ponent s of a theory, while qualitative studie s m ay merely be based on or seek to create a theory.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 190

3. A researcher is studying how anxiety affects coping with chronic dise ase and the orizes that me asures to reduce anxiety will improve subjects ability to cope with day-to-day demands of self-care. In this example, anxiety and coping are: a.assumptions. b.conce pts. c.philosophies. d.theories.

ANS: B Feedback AAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

BConcept s are terms that abstractly de scribe and name an object, ide a, experience, or phenomenon and are defined in specific ways to present the ideas relevant to a theory.

CPhilosophies are rational intellectual explor ations of truths or principles and de scribe viewpoints on what reality is and which ethical ideas should guide practice.

DTheories are sets of concepts that present a view of a phenomenon.

PTS:1DIF:Cognitive level: Applying (Application)

REF: pp. 190-191

4. When reviewing various theoretical fr ameworks, the nurse researcher identifies se veral viewpoints about how nurses should engage with terminally ill patients. These viewpoints represent: a.abstr act ideas. b.assumptions. c.concrete ideas. d.philosophies.

ANS: D Feedback AAn abstract idea focuses on a general view of a phenomenon.

BAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

CA concrete idea focuses on a particular instance.

DA philosophy is an ide a that explores truths or principle s and describe s which ethical ideas should guide practice.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

190-191

5. A nurse rese archer develops a study to assist patients with type 2 diabetes mellitus to lose weight by altering eating patterns. The rese archer st ates, Patients with type 2 diabete s mellitus desire to control weight to gain better glycemic control. This statement is a(n): a.assumption. b.conce pt. c.philosophy. d.theory.

ANS: A Feedback AAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

BConcept s are terms that abstractly de scribe and name an object, ide a, experience, or phenomenon and are defined in specific ways to present the ideas relevant to a theory.

CPhilosophies are rational intellectual explorations of truths or principles and de scribe viewpoints on what reality is and which ethical ideas should guide practice.

DTheories are sets of concepts that present a view of a phenomenon.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 190-191

6. A nurse researcher will me asure the effects of infant and parent bonding on infant weight gain in the first 6 months of life. The nurse will evaluate the number of times each day that the parent holds the infant. This measure is an example of a(n): a.abstr act idea. b.conce pt. c.concrete idea. d.phenomenon.

ANS: C Feedback AAn abstract idea is a general view of a phenomenon, such as parent/infant bonding.

BA concept is a term that abstractly describes a phenomenon.

CConcrete ideas refer to realities or actual instances, focusing on the particular and not the general.

DA phenomenon is the appear ance or aspect of reality as it is experienced.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192

7. The nurse researcher plans to evaluate self-care and its e ffects on dise ase prevention. The nurse identifies various health pr omotion activitiessuch as pr oper diet, exercise, and hours of sleep per nightas components of self-care. In this example, self-care is a: a.concept. b.construct. c.theory. d.variable.

ANS: A Feedback

AA concept is m ore abstract than a variable and represent s the name for an object or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measur able.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192

8. The nurse researcher plans to evaluate self-care and its e ffects on dise ase prevention. The nurse identifies various health pr omotion activitiessuch as pr oper diet, exercise, and hours of sleep per nightas components of self-care. In this example, health promotion is a: a.concept. b.construct. c.theory. d.variable.

ANS: B Feedback AA concept is m ore abstract than a variable and represent s the name for an objec t or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192

9. The nurse researcher plans to evaluate self-care and its effects on dise ase prevention. The nurse identifies various healt h promotion activitiessuch as pr oper diet, exercise, and hours of sleep per nightas components of self-care. In this example, hours of sleep is a: a.concept. b.construct. c.theory. d.variable.

ANS: D Feedback AA construct is a concept that has been created for the study. A construct is a broader category or ide a that may encompass several concepts.

BA concept is more abstract than a variable and repre sents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measur able.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-193

10. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The nurse identifies various he alth prom otion activitiessuch as proper diet, exercise, and hours of slee p per nightas components of self-care. In this example, effects of self-care on disease prevention is a: a.concept. b.construct. c.theory. d.variable.

ANS: C Feedback AA concept is m ore abstract than a variable and represent s the name for an object or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon. A conce ptual map include s all of the major concepts in a theory or framework.

DA variable is more specific than a concept and is variable and measur able.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192

11. Which is an important characteristic of a variable? a.It is broad and encompasses several ideas.

b. It is constant from one instance to another. c. It is less specific than a concept. d. It is measurable and changeable.

ANS: D Feedback A Variables are narrow in their definition.

B Variables vary from one instance to another.

C Variables are more specific than are concepts.

D A variable is more specific than a concept and is variable and measurable. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 191

12. Which is true about a conceptual definition in a rese arch study? a.It defines how a concept can be manipulated in a study. b. It describes how a concept may be measured in a study. c. It is comprehensive and includes associative meanings. d. It is more specific than a dictionary definition.

ANS: C Feedback AThe operational definition describes how the concept may be manipulated in a study.

BThe operational definition describes how the concept may be measured in a study.

CA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

DA conceptual de finition is m ore comprehensive than a denotative or dictionary definition and include s associated meanings the word may have.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 192

13. In a study about childhood obesity, the researcher discusses the concept of overweight in terms of weight for height measures, body m ass index (BMI), body im age, self -esteem, and social norms. When discussing body image, self-esteem, and social norms, the researcher is describing the:

a.conceptual definition. b.dependent variable . c.independent variable . d.operational definition.

ANS: A Feedback AA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

BThe dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or difference in the independent variable.

CThe independent variable is a me asur able variable that is manipulated by the researcher to observe possible changes in the dependent variable.

DThe operational definition describes how the concept may be measured or manipulated in a study.

PTS:1DIF:Cognitive le vel: Analyzing (Analysis) REF: MCS: 192

14. In a study about childhood obe sity, the researcher discusse s the concept of overweight in terms of weight for height measures, body mass index (BMI), body image , self -esteem, and social norm s. The researcher states that a BMI > the 95th percentile represents overweight. Thisstatement is a(n): a.conceptual definition. b.dependent variable . c.independent variable . d.operational definition.

ANS: D Feedback AA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

BThe dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or change in the independent variable.

CThe independent variable is a me asur able variable that is manipulated by the researcher to observe possible changes in the dependent variable.

DThe operational definition describes how the concept may be measured or manipulated in a study.

PTS:1DIF:Cognitive le vel: Analyzing (Analysis) REF: MCS: 192

15. A researcher discusse s how endorphins released during aerobic exercise cause a heightened sense of well-being in subjects. This discussion is a: a.conceptual definition. b.operational definition. c.relational statement. d.theoretical framework.

ANS: C Feedback AA conceptual de finition is more comprehensive than a denotative or dictionary definition and include s associated meanings the word may have.

BThe operational definition describes how the concept may be measured or manipulated in a study.

CA relational statement clarifies the type of relationship that exists between concepts.

DA theoretical framework de scribes abstract concepts and phenomena and is used t o guide nurses in clinical practice.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS : 193

16. When a rese archer analyzes data obtaine d from study variable s for possible significant relationships among these variables, the researcher is testing the: a.abstr act ideas. b.conce ptual definitions. c.relationship statements. d.study assumptions.

ANS: C Feedback AAn abstract idea focuses on a general view of a phenomenon.

BA conce ptual definition is more comprehensive than a denotative or dictionary definition and include s associated meanings the word may have. It does not identify relationships.

CA relational statement clarifies the type of relationship that exists between concepts.

DAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 193

17. Which statement is true about the hypothesis in a research study? a. It clearly identifies concepts. b. It is written at a higher level of abstraction than a general proposition. c. It is not testable. d. It makes a statement about specific relationships among variables.

ANS: D Feedback AThe hypothesis does not define concepts.

BThe hypothesis is written at a lower level of abstraction than a framework or proposition.

CHypothe ses are written to be tested in a study and make predictions about the relationships among variables.

DHypothe ses are written to be tested in a study and m ake predictions about the relationships among variables.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 193

18. Which nursing theorist developed a grand nursing theory? a.Brennam an b.Orem c.Pender d.Swanson ANS: B Feedback ABrennaman developed mid-level nursing theories.

BOrems theory is a grand nursing theory. CPender develope d mid-level nursing theories. DSwanson developed mid-level nursing theories.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 194

19. A nurse researcher discusses a theory about the stigma of chronic illness in children and describe s aspects of chronic illne ss including aesthetic qualities, cause s of the condition, and conce alability of the disease as dimensions of this stigm a. In this case, ae sthetic qualities, cause s of the condition, and concealability of the disease are: a.concepts. b.constructs. c.theories. d.variables.

ANS: B Feedback A A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

B A construct is a concept that has been created for the study. A construct is a broader category or ide a that may encompass several concepts.

C Theories are sets of concepts that present a view of a phenomenon.

D A variable is m ore specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 194

20. The level of theory often derived from evidence-based guidelines is: a.gr and theory. b.grounded the ory. c.mid-range theory. d.practice theory.

ANS: D Feedback AA grand theory is an abstract nursing theory.

BGrounded theory is theory derived from the analysis of data.

CA mid-range theory is narrower in scope than a grand theory.

DA specific type of mid-r ange the ory is a pre scriptive, or practice theory. These are often derived from evidence-based guidelines and are specific to situations.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 195

21. In the introduction to a study, the researcher explains why self-e steem is expected to affect obe sity.

The explanation of this relationship represents which aspect of the study? a.Concept b.Construct c.Framework d.Theory ANS: C Feedback A A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

B A construct is a concept that has been created for the study. A construct is a broader category or ide a that may encompass several concepts.

C A framework is an abstract, logical structure of meaning identifying how one variable is expected to affect another.

D Theories are set s of concepts that present a view of a phenomenon. PTS:1 DIF:Cognitive level: Applying (Application) REF: MCS: 198

22. Which will the researcher use to display the concepts and relationships in a theoreticalframework? a.Construct b.Graph c.Model d.Theory ANS: C Feedback

AA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

BA graph may be used in a model to depict variables.

CA model is a diagram or map that graphically displays concepts and relationships in a theory.

DTheories are sets of concepts that present a view of a phenomenon.

Chapter 9. Ethics in Research MULTIPLE CHOICE

1. The purpose of an institutional review board (IRB) in a university or clinical agency is to: a.approve funding for studies based on ethical standards. b.critically appr aise ethical aspects of publishe d studies. c.de fine ethical standards for the institution. d.protect the human rights of subjects in proposed studies.

ANS: D Feedback AIRBs do not approve funding for studies based on ethical standards.

BIRBs review ethical aspects of studies prior to the conduction of the study, not after they are published.

CIRBs do not define ethical standards.

DInstitutional review boards (IRBs) are organized to examine the ethical aspects of studies be fore they are conducted.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp.

94-95

2. An important initial focus of the Declaration of Helsinki, developed in 1964, was to: a.differentiate therapeutic from nontherapeutic research. b.de fine the concept of informed consent of rese arch subject s. c.prevent the use of placebos during clinical drug trials. d.prohibit nontherapeutic research to protect subjects from harm.

ANS: A Feedback AThe Declar ation of Helsinki was adopted in 1964 and its m ajor focus was to differentiate between therapeutic research and nontherapeutic research.

BThe Nuremberg code helped to define the concept of informed consent of subjects.

CThe Declar ation of Helsinki did not prevent the use of placebos, but declared that researchers must provide subjects in the place bo gr oup with access to prove n diagnostic and therapeutic procedures after the study.

DThe Declaration of Helsinki did not prohibit nontherapeutic research, but developed guideline s to address issues with this type of research.

PTS:1DIF:Cognitive le vel: Analyzing (Analysis) REF: MCS: 96

3. The Tuskegee Syphilis Study violated several ethical principles in which way? a.Coercion of subject s to participate in the study in exchange for treatment b.Failing to inform subjects about the purpose and procedures in the study c.Failing to inform in the Centers for Disease Control about the result s of the study d.Not informing the subjects physicians that they were in the study ANS: B Feedback A Subjects were not coerced by the promise of treatment, which was not offered, even when the benefits were known.

B In the Tuskegee Syphilis Study, subjects were not informed about the purpose and procedure s of the study; some were not even informed that they were subjects.

C The CDC was informed about the results and decided the study could continue.

D In the Jewish Chronic Dise ase Study, subjects physicians were not informed. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 97

4. After the Department of Health, Education, and Welfare (DHEW) regulations were published in 1973, all research using human subjects was required to: a.avoid using subjects who were ill, mentally impaired, or dying. b.obtain informed conse nt from all subject s prior to enrollment in a study. c.review only studies in which risk of harm to subjects is especially high. d.undergo full institutional review to examine risks and benefits to subjects.

ANS: D Feedback

AThe DHEW regulations do not prohibit using subjects who are ill, mentally im paired, or dying, but provided protections for such subjects.

BThe US Code of Federal Regulations requires informed consent of human subjects.

CDHEW regulations require institutional review of all human subjects, not just those with especially high risk.

DThe De partment of Health, Education, and Welfare regulations were published in 1973, providing for the protection of human research subject s and requiring full institutional review of all studies involving hum an subjects.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 98

5. The ethical principles of respect for persons, beneficence, and justice are considered essential elements in research involving human subjects. In which document are these principles identified? a.Declaration of Helsinki b.Department of Health, Education, and Welfare regulations c.National Commission for the Protection of Human Subjects in the Belmont Report d.Nuremberg Code ANS: C Feedback AA major focus of the Declaration of Helsinki was the differentiation of therapeutic research fr om nontherapeutic research.

BThe Department of He alth, Education, and Welfare regulations were published in 1973 providing for the protection of human research subjects.

CThe National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was formed in the United States in 1978. This commission developed ethical rese arch guideline s based on the ethical principles of respect for persons, beneficence , and justice and made recommendations to the U.S. Department of Health and Human Services (DHHS) in the Belmont Report.

DThe development of the Nuremberg Code in 1949 addressed the mistreatment of human subjects.

PTS: 1 DIF: Cognitive level: Knowledge REF: pp. 98-99

6. Which ethical principle protects human subjects from harm? a.Beneficence b.Ethics

c.Justice d.Respect for persons ANS: A Feedback AThe ethical principle of beneficence encourages the researcher to do good and to do no harm.

BEthics is not a specific ethical principle.

CThe principle of justice addresses the fair treatment of human subjects.

DThe principle of respect for per sons indicates that human subjects should be treated as autonomous agents with rights to self-determination.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

98-99

7. When conducting rese arch to study medical de vices for human use, the nur se researcher must com ply with the Department of Health and Human Service s hum an subjects regulations as well as regulations put forth by the: a.American Nurse s Association b.Code of Feder al Regulations c.Food and Drug Administration d.Presidential Commission for the Study of Bioethics ANS: C Feedback AThe ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

BThe ANA, CFR, and the Preside ntial Commission do not have specific regulations governing rese arch of medical devices.

CThe FDA and the DHHS regulations govern most of the biomedical and behavioral rese arch conducted in the United States. Drugs, medical device s, biological products, hum an dietary supplements, and electronic devices are all regulated by these two entities.

DThe ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: pp. 99100

8. To safeguard the right to self-determination among research subjects, the researcher will ensure that subjects: a.are afforded anonymity to the researcher and the reader. b.are allowed to choose whether to be in a control or a study group. c.may choose whether or not to participate in a study. d.receive a large monetary reward for participating in the study.

ANS: C Feedback A The right to anonymity means that subjects cannot be identified.

B Subjects are generally randomly assigned to groups.

C Self-determination refers t o individuals rights t o knowingly become a subject in the study or not, and t o do so of their own free will.

D Subjects who are given large rewards for participation may be coerced. PTS:1 DIF:Cognitive le vel: Applying (Application) REF: MCS:101

9. The greatest risk to a person confined to an institution who is a research subject is: a.diminished autonomy. b.discomfort. c.lack of information. d.lack of privacy.

ANS: A Feedback APersons who are vulnerable because of legal or mental incompetence, terminal illness, or confinement to an institution have diminished autonomy.

BThey are not necessarily at higher risk for discom fort, lack of information, or lack of privacy than are other subjects.

CThey are not necessarily at higher risk for discom fort, lack of information, or lack of privacy than are other subjects.

DThey are not necessarily at higher risk for discomfort, lack of inform ation, or lack of privacy than are other subjects.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: pp. 99100

10. A researcher will have greater success gaining approval for a research study involving pregnant women if which provision is put into place? a.Care is taken to maintain strict confidentiality of subjects. b.Consent is given by the pregnant womens significant others. c.Subjects m ay experience therapeutic effects from the intervention. d.Subjects receive financial rewards for participation in the study.

ANS: C Feedback A Confidentiality and consent must be maintaine d in all rese arch involving hum an subjects and do not influence approval for subjects with diminished capacity.

B Confide ntiality and consent must be maint ained in all research involving human subjects and do not influence approval for subjects with diminished capacity.

C Pregnant women are considered to have legal and/or mental diminishment of autonomy. Research involving such subjects is generally more acceptable if the research is therapeutic.

D Financial rewards m ay be a form of coercion.

PTS:1DIF:Cognitive level: Applying (Application) REF:pp.

101-102 |MCS: 104

11. When a researcher indicate s that assent for participation was gaine d in a study involving 10 year-old children, this indicates which has occurred? a.The children gave informed conse nt to participate in the study. b.The children have agreed to be subjects in the study. c.The parents granted approval for their children to participate. d.The parents do not need to give consent because the children gave consent.

ANS: B Feedback AAssent is not informed consent, which must be given by a childs parent or legal guardian. BAssent is gained from children who are subject s and represent s their agreement to participate. CAssent doe s not represent approval by the parents.

DAssent is given in conjunction with informed consent by the parent or legal guardian and is not sufficient by itself to allow a minor to participate in a study.

PTS:1DIF:Cognitive level: Applying (Application)

REF: MCS: 102

12. A researcher wishes to study the effects of antiseizure medications on adult subjects who have severe cognitive impairments. Which statement is true about using these subjects in research? a.Assent must be gained from the subjects and is sufficient for participation. b.A legally authorized guardian must give informed consent. c.These adults cannot be used as subjects for this study. d.The subjects physicians must give consent for participation in the study.

ANS: B Feedback A Assent must be gained if possible, but is not sufficient for participation in a study.

B Persons with mental illness or a cognitive impairment are incapable of giving informed conse nt. A researcher must gain approval from a legally authorized representative or guardian along with gaining assent from the participant.

C Adults with mental im pairments m ay be used in studies as long as their rights are protected and proper consent is obtained.

D Physicians are not legally authorized representatives.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 104

13. A researcher makes e very effort to ensure that subjects may be nefit from a rese arch intervention while taking measures to minimize potential harm. This is an example of protecting a research subjects right to: a.anonymity and confidentiality. b.fair treatment. c.protection from discomfort and harm. d.self-determination.

ANS: C Feedback ACom plete anonymity exists if the subjects identity cannot be linked, even by the researcher, with his or her individual response s. Confidentiality is the safe management of private information shared by a subject. The researcher must refrain from sharing that information

without the authorization of the subject. Rese arch findings need to be reported so that a subject or group of subjects cannot be identified.

BThe right to fair treatment suggest s that pe ople should be treated fairly and should receive what they are due or owed.

CThe right to protection from discomfort and harm from a study is based on the ethical principle of beneficence, which states that one should do good and, above all, do no harm.

DSelf-determination refers to individuals rights to knowingly become a subject in the study or not and t o do so of their own free will.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

100-101

14. When obt aining informed consent fr om study subjects, the rese archer will ensure that subjects freely choose whether or not to participate and will provide subjects: a.general knowledge and overview of the study. b.information about the study methods and design. c.reports about the study results and conclusions. d.the right to choose whether to be in the control versus the study group.

ANS: A Feedback AInformed consent includes disclosure t o the subject of e ssential study information, com prehension of this information by the subject, com petence of the subject to give consent , and volunt ary consent of the subject to participate in the study.

BInformation on the study design is give n only as it applie s to what will happen t o the subject. The correct answer is general knowledge and com prehension of the study. Informed consent includes disclosure to the subject of essential study information, comprehension of this inform ation by the subject, competence of the subject to give consent, and voluntary consent of the subject to participate in the study.

CIt is not necessary to pr ovide reports about the study re sults and conclusions as part of gaining informed consent.

DSubjects are generally randomly assigned t o control versus study groups and choice of placement is not a part of informed consent.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

100-101

15. A special concern when conducting research using terminally ill cancer patients as subjects is:

a.an inability to randomly assign subjects to study groups. b.an increased risk of harm with decrease d bene fits. c.difficulty enlisting subjects for participation in the study. d.poor control of extraneous variables.

ANS: B Feedback ASubjects may still be randomly assigned to control versus study groups.

BParticipating in research may carry increased risks with minimal or no benefits for terminally ill subjects.

CTerminally ill patients may be more likely to be willing to participate in research.

DThere is no difference when controlling extraneous variables in studies involving terminally illpatients.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 104

16. Which subject groups may feel especially coerced to participate in research studies? a.Children b.Institutionalized patients c.Pregnant women d.Terminally ill patients ANS: B Feedback AChildren, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

BPersons confined to institutions may feel coerced to participate in research because they fear harm or because they feel that they may receive special benefits for participation.

CChildren, pregnant women, and terminally ill patients are allowe d to give assent or consent freely for participation in research.

DChildren, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

PTS:1DIF:Cognitive level: Knowing (Knowledge) REF: MCS: 104

17. If a he alth care pr ovider discloses inform ation about a patient to a researcher for a study, the pr ovider and the researcher must have a(n): a.agreement about the studys pur pose. b.data use agreement. c.limited data set. d.written study proposal.

ANS: B Feedback A Agreement about the studys purpose is not necessary for sharing information.

B A data use agreement limits how dat a may be used and how it will be protected and must be in place for a provider to disclose data to a researcher.

C A limited data set describes the type of data that may be disclose d without an individual subjects authorization or an IRB waiver; in order to disclose this limited data set, a data use agreement must be in place.

D The written study proposal does not confer the right to disclose patient data t o a re searcher.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 106

18. In a study about pregnant womens use of tobacco, the researcher is able to link individual subjects identities to their response s on a que stionnaire, but doe s not share this information with others. This is an example of: a.anonymity. b.breach of confidentiality. c.confidentiality. d.privacy.

ANS: C Feedback AAnonymity exists when the subjects identity cannot be linked, even by the researcher, with individual responses.

BA breach of confide ntiality occur s when a researcher allows an unauthorized person t o gain acce ss t o the raw data of a study.

CConfidentiality is the researchers safe management of inform ation or data shared by a subject to ensure the data are kept private.

DPrivacy is a larger concept encompassing anonymity and confidentiality.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

106-107

19. A researcher using a small sample of an e asily distinguishable group of subject s wishe s to use extensive quotes in the research report. This researcher risks: a.a loss of study validity. b.breaching confidentiality. c.losing objectivity. d.reduction of benefits to subjects.

ANS: B Feedback AStudy validity is related to the proper use of study tools and measurements.

BBreach of confidentiality is of special concern in qualitative studie s that have fe w study participant s and involve the reporting of long quotes.

CObjectivity is the ability of the researcher to avoid interpreting results in a biased manner.

DBenefits to subjects are not necessarily compromise d in small studie s using quotations.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 106-107

20. A subjects right to fair selection and treatment in a study is related to which ethical principle? a.Beneficence b.Justice c.Privacy d.Respect for persons ANS: B Feedback AThe principle of beneficence requires that subjects are protected from harm.

BThe right to fair selection and treatment of subjects is based on the ethical principle of justice, requiring people to be treated fairly and to receive what they are owed.

CThe principle of privacy requires that anonymity and confidentiality are protected.

DThe principle of respect for persons requires that human subjects should be treated as autonomous agents with rights to self-determination.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

107-108

21. Which unethical study in previous history involved withholding a treatment from subjects in order to study the effects of a disease progression on subjects? a.The Jewish Chronic Dise ase Hospit al Study b.The Nazi Medical Experiments c.The Tuskegee Syphilis Study d.The Willowbrook Study ANS: C Feedback AIn the Jewish Chronic Dise ase Hospital Study, subjects were injected with a suspension containing live cancer cells and did not know they were taking part in a study or that the injections cont ained these live cancer cells.

BIn the Nazi Medical Experiments, an array of atrocious unethical medical experiments were conducted on prisoners of war.

CIn the Tuskegee Syphilis Study, penicillin was deliberately withheld from the research subjects and their families, in order to study the effects of the natural progression of syphilis.

DIn the Willowbrook Study, mentally retarded children were infected with the hepatitis virus and new patients were not admitted to this institution unle ss their parents consented for their children to participate in this study.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 97

22. A researcher conducts a study to evaluate the frequency of intimate partner violence among females treated for sexually transmitted diseases (STDs). When collecting dat a, which action may be problem atic when protecting subjects rights? a.Allowing subject s to decline participation in the study b.Approaching all patients who meet eligibility requirements c.Identifying subjects with numbers instead of names d.Instructing subject s to complete every item on the questionnaire ANS: D Feedback

AAutonomy is protected when subjects are informed that participation is volunt ary. BApproaching all subjects who meet eligibility requirements removes the possibility of bias. CUsing num bers instead of names helps to protect privacy.

DSubjects who are told that they must complete every item on a que stionnaire risk losing their right to autonomy.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 101

23. A researcher gives healthy adult subjects a handout explaining the nature of a study and then obt ains written consent from those who choose to participate. Which statement is true about this process? a.Subjects have given informed consent for participation in the study. b.Subjects have not given voluntary consent for participation in the study. c.The researcher has faile d to determine comprehension of the study by participants. d.The researcher has not disclosed information about the study to the participants.

ANS: C Feedback AInformed consent implie s not only that the researcher has imparted information to the subjects, but also that the prospective subjects have com prehended the information. The rese archer needs to discuss the information with the subjects and ask them to restate the information to assess their understanding.

B The subjects have voluntarily consented to participate.

C These subjects have been given written inform ation, but have not stated their underst anding, so informed consent has not been obtained.

D The researcher disclosed information to the subject s about the study.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 112

24. Which situation may allow waiving the need to obtain written consent for participation in a research study? a.The researcher is conducting an inform al study about heart disease. b.The researcher is using questionnaires to collect dat a about suicide risk. c.The subject s do not want document ation linking them to the study. d.The subjects desire complete anonymity in the study.

ANS: C Feedback A Informal studies and those using questionnaires about potentially harmful subjects do not meet the requirements for waiving of consent.

B Informal studie s and those using que stionnaires about potentially harmful subject s do not meet the requirements for waiving of consent.

C Subjects who do not want document ation linking them to the resear ch who have received information and demonstrated comprehension of the information may have consent waived if they desire.

D Anonymity can be maintained even with signed consent. PTS:1DI F:Cognitive level: Applying (Application) REF: MCS: 114

25. Which federal agency was est ablished to manage investigations of misconduct in research? a.Department of Health, Education, and Welfare (DHEW) b.De partment of Health and Human Services (DHHS) c.Food and Drug Administration (FDA) d.Office of Research Integrity (ORI) ANS: D Feedback AThis is not a correct statement.

BThis is not a correct statement.

CThis is not a correct statement.

DThe Office of Research Integrity was developed by the federal government in 1989 to supervise the implementation of the rules and regulations related to rese arch misconduct and to manage any investigations of misconduct.

PTS: 1 DIF: Cognitive level: Understanding (Com prehension) REF: MCS: 122

26. A researcher makes an honest error when tabulating and analyzing research findings. According to the Office of Research Integrity, this constitutes: a.fabrication. b.falsification. c.misrepresentation.

d. no misconduct.

ANS: D Feedback A Fabrication refers to making up results and recording or reporting them.

B Falsification is manipulating research materials, equipment, or proce sse s, or changing or omitting dat a or results so that the research is not accurately represented.

C Misrepresentation refers to presenting data inaccurately.

D A researcher making an hone st error is not guilty of misconduct. PTS: 1 DI F: Cognitive level: Understanding (Comprehension) REF: MCS: 122

27. Which is an example of falsification in research? a.Citing work by another researcher and claiming it as one s own. b.Making up statistics about the incidence of reactions t o an intervention. c.Omitting data about a subject that dispr oves the researcher s hypothesis. d.Using dat a gained without the consent of the research subjects.

ANS: C Feedback A Plagiarism is citing anothers research and claiming it as ones own.

B Fabrication involves making up results and reporting them.

C Falsification is m anipulating rese arch materials, equipment, or proce sse s, or changing or omitting data or results so that the research is not accurately represented.

D Lack of informed consent occur s when the rese archer fails to gain consent from study subjects.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 122

28. A researcher com bines dat a from another researchers study along with data from the reported study in graphs without noting the source of the data. This is an example of: a.an hone st error. b.fabrication. c.falsification. d.plagiarism.

ANS: D Feedback A An honest error would occur if the researcher was unaware that the data belonged to someone else.

B Fabrication involves making up results and reporting them.

C Falsification is m anipulating rese arch materials, equipment, or proce sse s, or changing or omitting data or results so that the research is not accurately represented.

D Plagiarism is citing anothers research and claiming it as ones own. PTS:1 DIF:Cognitive level: Applying (Application) REF: MCS: 122 MULTIPLE RESPONSE

1. Which patient information requires deidentifying in order to maintain privacy? (Select all thatapply) a.E-m ail addre sse s b.Fullface phot ographs c.St ate of residence d.Medical record numbers ANS: A, B, D Feedback Correct E-m ail addresses, full-face photographs, and medical record num bers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

E-mail addresses, full-face phot ographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

E-mail addresses, full-face phot ographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

IncorrectThe state of residence is not necessarily an identifier, but any geographic division sm aller than a state is.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 106

2. According to the HIPAA privacy rule s, which are covered entities that may use and disclose a limited data set to researchers for study? (Select all that apply) a.Health plans b.Health care providers c.Institutional Re view Boar ds d.Researchers ANS: A, B Feedback Correct Health care providers, health plans, and health care clearinghouses are covered entities.

Health care providers, health plans, and health care clearinghouses are covered entities.

IncorrectThis is not a correct statement. This is not a correct statement.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 106

3. Which of the following represent some degree of risk of causing discomfort or harm to subjects in a study? (Select all that apply) a.Asking parents of children in a clinic waiting room to complete a patient satisfaction questionnaire. b.Asse ssing the number of m ales and fem ales enrolle d in nursing schools using enrollment data. c.Interviewing nursing home residents about their memories of the Great Depression. d.Using pathology reports from a hospital lab to gain dat a about the percentage of new patients who have anemia.

ANS: A, C, D Feedback Correct Asking parents to complete a que stionnaire increases the risk of temporary discom fort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer bene fits to the subjects and may run the risk of invasion of privacy.

Asking parents to complete a questionnaire increase s the risk of temporary discom fort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer bene fits to the subjects and may run the risk of invasion of privacy.

Asking parents to complete a questionnaire increase s the risk of temporary discom fort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer bene fits to the subjects and may run the risk of invasion of privacy.

IncorrectAssessing the numbers of males and females does not increase risk or cause discomfort.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 108

4. A researcher wants to study whether showing a video about car safety increases the likelihood of car seat use am ong a group of fir st-time parents. When obtaining informed consent, the re searcher must include: (Select all that apply) a.an assurance of anonymity. b.a st atement of the research purpose. c.consent to incomplete disclosure. d.voluntary participation.

ANS: A, C, D Feedback Correct Anonymity and volunt ary participation must be assured in all rese arch involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or notthey view the video.

Anonymity and volunt ary participation must be assured in all research involving hum an subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or notthey view the video.

Anonymity and volunt ary participation must be assured in all research involving hum an subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or notthey view the video.

IncorrectIn some case s, a statement of the research purpose can influence the results and a conse nt to incomplete disclosure may be obtained instead.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 111

5. A researcher has submitted a proposal to an Institutional Review Board (IRB) to evaluate the effects of a new drug on newborn infants. In this case, members of the IRB should include: (Select all that apply) a.an ethicist. b.a hospital pharmacist. c.a neonatologist. d.a pharmaceutical representative.

ANS: A, B, C Feedback Correct When selecting an IRB, there must be at least five members of varying backgr ounds to prom ote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharm acist would both be include d in this case . All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

When selecting an IRB, there must be at least five members of varying backgr ounds to prom ote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharm acist would both be include d in this case . All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

When selecting an IRB, there must be at least five members of varying backgr ounds to prom ote a complete, scholarly, and fair review of research. When vulner able subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharm acist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

IncorrectA pharmaceutical representative would have a conflict of interest in promoting the drug.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 117

6. A nurse rese archer who wishe s to use animals in a rese arch study must include which elements in an animal use protocol? (Select all that apply) a.Anim al living conditions and veterinary care b.Assur ances that animals will be kept alive c.Justification for the use of animals over humans d.Procedures to minimize pain and distress ANS: A, C, D Feedback Correct Elements of animal use prot ocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

Researches need to ide ntify methods of euthanasia and do not need assurance s that anim als will be kept alive.

IncorrectElements of anim al use prot ocols should include de scriptions of anim al living conditions and veterinary care, justifications for the use of anim als, and proce dures that will minimize pain and distress.

Elements of anim al use prot ocols should include descriptions of anim al living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

Chapter 10. Quantitative Methodology: Noninterventional Designs and Methods MULTIPLE CHOICE

1. Which type of research design focuse s on implementation of a treatment by the researcher? a.Correlational b.De scriptive c.Experimental d.Longitudinal ANS: C Feedback ACorrelational and descriptive designs are nonexperimental studie s that focus on examining variable s as they naturally occur and not on the implementation of a treatment by the researcher.

BCorrelational and de scriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

CQuasi-experimental and experimental studies are designe d to examine causality between a rese archerimplemented treatment and a study outcome.

DLongitudinal design refers to data collection from the same subjects at different points in time and may or may not be used with experimental or nonexperimental studies.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 212

2. A researcher administers a written test to evaluate knowle dge of insulin administration and glucose monitoring to a group of subjects at annual intervals over the next decade. This is an exam ple of which type of study design? a.Correlational b.Cross-sectional c.Descriptive d.Longitudinal ANS: D Feedback A Correlational studie s see k to ex amine relationships among variable s without manipulation of a treatment by the researcher.

B Cross-sectional de signs examine a group of subjects simultaneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation of variables.

D Longitudinal design refers to data collection from the same subjects at different points intime.

PTS: 1 DIF: Cognitive level: Application REF: MCS: 212

3. A nurse researcher wishes to ide ntify rates of pertussis infection in children less than one year of age and then again at 6 years of age to examine the relationship of immunization status on infection rates in this population. This is an example of which type of study de sign? a.Correlational, longitudinal b.Correlational, cross-sectional c.Descriptive, longitudinal d.Descriptive, cross-sectional ANS: A

Feedback AA correlational study design looks at predictive relationships between variable s. A longitudinal study de sign refers to data collection from the same subjects at different points in time.

BCross-sectional de signs examine a group of subjects simult aneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation.

D Cross-sectional designs examine a group of subject s simultaneously in various st ages of de velopment , illness severity, or recovery to identify changes in a phenomenon across st ages. A descriptive study is used to examine variables as they occur naturally without manipulation.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 212

4. Which statement is true about a descriptive study design? a.It is not possible to oper ationally define variable s in this type of study. b.Sam ple selection and size cannot be controlled in descriptive studie s. c.This type of design is used to identify pr oblems occurring in practice. d.Variable s may be manipulated to avoid bias in this type of study.

ANS: C Feedback ADescriptive designs may involve oper ational definitions of variables, but variables are not manipulated in descriptive studies.

BProtection against bias in a descriptive design is achie ved through conceptual and oper ational de finition of variables, sample selection and size, valid and reliable instruments, and dat a collection proce dures that partially control the environment.

CDescriptive designs may be used to develop theories and identify problems with current practice.

DProtection against bias in a descriptive design is achieved through conceptual and operational de finition of variables, sample selection and size, valid and reliable instruments, and dat a collection procedures that partially control the environment.

PTS: 1 DIF: Cognitive level: Understanding REF: pp. 212-213

5. A nurse conducts a study to see whether there are differences in the number of books Latino parents and the number of books African -American parents read t o their toddlers each week. Which type of study will this researcher utilize? a.Comparative b.Correlational c.Cross-sectional d.Longitudinal

descriptive

ANS: A Feedback A A comparative de scriptive design is used to de scribe variable s and to examine differences in variables in two or m ore groups that occur natur ally in a setting that may have been formed using gender, age, or socioeconomic status.

B A correlational study design looks at predictive relationships between variables.

C Cross-sectional designs examine a group of subject s simult aneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

D Longitudinal design refers to data collection from the same subjects at different points intime.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 216

6. A researcher wishes to conduct a correlational study t o determine whether there is a relationship between stress le vels and relapse rates among patient s who have chronic conditions. In order to determine the existence of a relationship between these two variables, the researcher will attempt to: a.manipulate the level of stress in study subject s. b.obtain a large range of possible scores. c.provide lengthy descriptions of subjects behavior s. d.randomly assign subjects to study groups.

ANS: B Feedback A Correlational studies do not involve manipulation of a variable.

B In correlational de signs, a large r ange in the variable score s is necessary t o determine the existence of a relationship.

C Providing le ngthy descriptions of subjects behaviors is a necessary part of the discussion of the result s, but it does not determine the existence of a relationship.

D Subject s in correlational studies are not randomly assigned to study groups. PTS: 1 DIF: Cognitive level: Applying REF: MCS: 217

7. If a researcher wishes to describe variables and to examine many relationships in a study, which type of study design will the researcher employ? a.Correlational b.De scriptive c.Descriptive correlational d.Descriptive cross-sectional

ANS: C Feedback ACorrelational studies seek to examine relationships am ong variables without m anipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA de scriptive correlational design is use d to describe variables and examine relationships am ong the se variables. Using this design facilitates the identification of many interrelationships in a situation.

DCross-sectional designs examine a group of subject s simultane ously in various stage s of development, illness severity, or recovery to identify changes in a phenomenon across stages.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 218-220

8. A nurse researcher conducts a study to determine whether women who breastfeed their infant s experience better sleep in the first two postpartum months. This study will employ which type of research design? a.Correlational b.De scriptive c.Descriptive correlational d.Predictive correlational ANS: D Feedback ACorrelational studies seek to examine relationships am ong variables without m anipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA de scriptive correlational design is used to de scribe variables and examine relationships among these variables.

DA predictive correlational design is use d to predict the value of one variable based on t he values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 220

9. A researcher theorizes a set of relationships among concepts used t o de scribe why patients with chronic illness are often depressed. To test the accuracy of these hypothesized relationships, which type of study will be used?

a.De scriptive correlational b.Grounded theory c.Model testing d.Predictive correlational ANS: C Feedback AA de scriptive correlational design is used to describe variables and examine relationships among the se variables.

BGrounded theory research is designed to generate theory and to develop new concepts.

CThe model testing design requires all concept s relevant to the model be measured and the relationships among these concepts examined.

DA predictive correlational design is use d to predict the value of one variable based on t he values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 221

10. A researcher conduct s a study to examine possible contributor s to glycemic control in a gr oup of subjects who have type 2 diabetes mellitus in a local community. A convenience sample of patients include s patients from 28 to 65 years old who range in weight fr om normal to obe se, with time since diagnosis ranging from several months to several years. To determine causality in this study, the researcher will: a.discuss outcome s in terms of the probability that education will impr ove glycemic control. b.increase the manipulation of the independent variable to allow greater control by the researcher. c.identify multicausal variable s that may influence the outcome of glycemic control measures. d.limit the study to younger persons only to minimize the effects of extraneous variables.

ANS: C Feedback A Probability addre sse s relative and not absolute causality and may be used when given e ffects are not produced consistently.

B In this case, incre asing the manipulation of the inde pendent variable does not alter the influence of multiple causes.

C Multicausality is the presence of multiple cause s for an effect. In this study, patient age, weight, and length of time of diagnosis may all influence the outcome and should be addresse d as fact ors that may alter the results.

D Limiting the study to patients of a certain age only controls for one extraneous variable . PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 223

11. A study in which subjects are assigned by the researcher into experimental and control groups increases: a.bias. b.control. c.manipulation d.validity.

ANS: A Feedback A Bias occurs when the attitudes or motivations of the researcher cause a deviation from a true measurement of the study variables. This m ay occur when researchers control assignment to study groups.

B Control is used to manage m anipulation of variable s and to reduce extraneous fact ors in the environment that might alter outcomes.

C Manipulation of independent variables is used to evaluate changes in dependent variables.

D Researcher control over assignment into groups does not increase a studys validity. PTS: 1 DIF: Cognitive level: Understanding REF: MCS: 223

12. In a quasi-experimental study examining the effects of nonpharm acologic treatments on post operative pain m anagement, the researcher trains nur sing staff so that all experimental group subjects receive the same types of treatments. This is an example of: a.bias. b.manipulation. c.reliability. d.validity.

ANS: B Feedback A Bias refers to interference by the researcher that influences the outcome of a study.

B Manipulation is a form of control used in quasi-experimental and experimental studie s and may involve control of the intervention so that it is applied consistently.

C Reliability and validity are related to consistency and trustworthiness of measurement tools.

D Reliability and validity are related to consistency and trustworthiness of me asurement tools. PTS: 1 DIF: Cognitive level: Applying REF: MCS: 224

13. A researcher conducts a quasi-experimental study t o determine whether there is appropriate weight gain among premature infant s who are fed according to cue -based pr otocols. The rese archer trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d according to cue-based protocols and those fed according to st andard protocols. The reviewer critiquing the study notes that not all nurse s completed the cue-based feeding module. This would affect which type of validity? a.Construct validity b.External validity c.Internal validity d.Statistical conclusion validity ANS: D Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accur ate reflection of the real world. This can be threatened by anything interfering with consistent implementation of a variable, including inadequate training of individuals who im plement the intervention.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225

14. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infant s who are fed according to cue -based pr otocols. The rese archer trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d according to cue-based protocols and those fed according to st andard protocols. The reviewer notes that components of cue -based feedings are not clearly identified. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: A Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

15. A researcher conduct s a quasi-experimental study to determine whether there is improved weight gain among premature infant s who are fed according to cue-based pr otocols. The researcher trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d according to cue-based protocols and those fed according to standard protocols. Which might be a threat to internal validity in this study? a.The concept of cue-based feeding is not well defined. b.The study sample is homogeneous. c.Some infants developed gastroenteritis. d.Not all nurses received cue-based protocol education.

ANS: C Feedback AInadequate definitions of constructs are threats to construct validity.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

A study with a more homogenous sample is less likely to have findings that can be generalized to other populations.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. If not all nur ses received cue -based education, the intervention implementation will be unreliable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

16. A researcher conduct s a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The

researcher trained ne onat al intensive care nurse s to apply cue -based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue -based prot ocols and those fed according t o standar d protocols. The reviewer notes that parents who gave consent to participate in the study were from a higher socioeconomic class than the population as a whole. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

17. A researcher develops a 7-point Likert scale to evaluate feelings of well-being in patients who are undergoing chemotherapy. The researcher administers this measure to other, similar patients in other medical centers. This is done in order to: a.decrease mono-operation bias. b.improve the test-retest reliability. c.increase interrater reliability. d.strengthen the operational definition of constructs.

ANS: B Feedback AMono-operation bias occurs when only one measure is used to evaluate an outcome.

BTo improve the reliability of the measurement tool, it should be tested in various settings to determine whether it gives consistent measures each time it is used.

CInterrater reliability refers to consistent results that occur when various people administer study measures.

DEvaluating the consistency of a measurement tool does not affect the operational definition of constructs.

PTS: 1 DIF: Cognitive level: Analysis REF: pp. 225-226

18. In a research study, am bulatory clinic nurse s teach children with asthm a how to monitor pe ak expirat ory flow volumes and how to use metered-dose inhalers to determine whether asthma control scores improve .

The researcher discovers inconsistencies in how these measures were taught and how well the children understood the concepts. This represents a lack of: a.control of extraneous variables. b.internal validity. c.intervention fidelity. d.precision of measurement.

ANS: C Feedback ATo control for extraneous variables, the researcher would identify char acteristics of subjects or settings that might influence outcomes.

BInternal validity looks at the influence of extraneous variables on study outcomes.

CConsistent im plementation of the treatment is referred to as intervention fidelity. If the method of administering a research intervention varies from one person to another, the chance of identifying a true difference based on the independent variables decreases.

DPrecision of measurement refers to whether or not the tools yield the same readings or findings from one test to another.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226

19. A researcher wishe s to conduct a study of a small number of subjects on a large hospit al intensive care unit. To minimize problems associated with extraneous variable s in the study setting, the researcher will: a.ensure double-blind data collection methods. b.randomly assign subjects to treatment and control groups. c.test the reliability of study measures. d.train a small number of nurses to administer the intervention.

ANS: D Feedback

ADouble-blind data collection, random assignment of subjects, and reliability of te st measure s are important to improve control and reduce bias.

BExtraneous variables in complex settings can influence scores on the dependent variable.

CDouble-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

DOne way to reduce the effect of extraneous variables is to train a small num ber of staff to administer the intervention to improve consistency.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

20. A researcher reviews demographic char acteristics of potential study subjects, such as age and gender, to determine whether these characteristics may influence the outcome of the study. This is done to help ensure: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226

21. An important measure to decrease threats to internal validity in an experimental study is to: a.apply t he intervention consistently. b.improve the precision of measurement methods. c.increase the sample size. d.randomly assign subjects to study groups.

ANS: D Feedback

AConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

BConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

CIncreasing sample size minimizes threats to external validity.

DAn important threat to internal validity is any concern about subject selection and assignment to groups.

Randomly assigning subjects to treatment and control groups helps to minimize thisthreat.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225

22. Which action will the researcher take to improve construct validity? a.Allow data collectors to know which subjects are assigned to which groups b.Ensure that operational definitions reflect theoretical constructs c.Make sure that the rese archer is involved in data collection d.Utilize only one measurement method to measure study variables ANS: B Feedback A Allowing data collectors to know which subjects are assigned to which gr oups and involving the researcher in data collection both increase the risk of bias.

B Construct validity de pends on adequate definition and measurement of constructs. The conceptual definition should emerge from the concept analysis and the operational definition should cle arly reflect both.

C Allowing data collectors to know which subjects are assigned to which groups and involving the rese archer in data collection both increase the risk of bias.

D Using only one measurement tool increases the risk of mono-operation bias. PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

23. A researcher wishes to study the effects of effective s leep hygiene on slee p quality and behavior among children diagnosed with attention deficit disorder. To minimize mono-operation bias, the researcher will: a.accurately de scribe conceptual and operational definitions. b.adequately discuss construct validity in the introduction. c.evaluate multiple sleep hygiene techniques. d.utilize a double-blind data collection methodology. ANS: C

Feedback A Construct validity is improved with adequate description of conceptual and operational definitions.

B Construct validity is improved with adequate description of conceptual and operational definitions.

C Mono-operation bias occur s when only one method of measurement is used to assess a construct and can be minimized with the use of multiple measures.

D Use of double-blind data collection methods helps to minimize bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225|MCS: 228

24. Multiple replications of an initial study conducted in different populations produce findings that do not match those in the initial study. The initial study may lack which type of validity? a.Construct validity b.External validity c.Internal validity d.Statistical conclusion validity ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

25. In order to increase participation am ong potential subjects of a larger population, the researcher will: a.limit the time and effort required to participate in the study. b.provide demographic information about those who refuse to participate. c.provide instruments that are detailed to increase the amount of data collected. d.offer potential subjects a financial incentive to participate in the study.

ANS: A Feedback

ALimiting the investment demands on subjects helps to improve participation.

BProviding demographic information about those who do not participate is an important part of the discussion of limitations of a study but does not ensure generalization to a larger population.

CDetailed instruments may be time consuming and may limit participation to a small sample size.

DOffering financial incentives does not ensure a sample that is representative of the larger population.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

26. In order to attribute causality of a posttest measure in an experimental study, the independent variable will be: a.administered to control group subjects only. b.administered to subjects selected by the researcher. c.administered to treatment group subjects. d.defined loosely to avoid bias.

ANS: C Feedback AThe independent variable is administered to the treatment group and not the control group.

BSelection of subjects by the researcher increases the likelihood of bias.

CTo improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group.

DThe independe nt variable should be precisely define d. PTS: 1 DIF: Cognitive level: Applying REF: pp. 229-230

27. In a study to examine the effects of a newly modified anxiety-reducing nursing action on a group of subjects who have cancer, the control group will receive: a.an alternative intervention. b.no intervention. c.the newly modified intervention. d.the standard intervention.

ANS: D Feedback AAn alternative intervention would invite comparison, but if it is new, it would also beexperimental.

BOffering no intervention is often unethical.

CGiving the newly modified intervention would not create a difference between the treatment and the control groups.

DIn many nursing studies, offering no intervention (when one exist s) to subject s in the control group is considered unethical. Subjects in this group generally receive the standard intervention as a com parison to those in the treatment group.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232

28. In a quasi-experimental study design, the group that receives standard care is usually referredto as the: a.com parison group. b.control group. c.experimental group. d.treatment group.

ANS: A Feedback AIn a quasi-experimental study, the group that doe s not receive treatment is usually referred to as the comparison group.

BSubjects not receiving treatment in an experimental group are generally referred to as the control group.

CGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

DGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232

29. In a quasi-experimental study using a convenience sample of subjects fr om a local high school, the researcher asks potential subject s to volunteer for placement in either a low sugar diet program or a regular sugar diet program. This technique for assigning participation may compromise: a.construct validity. b.external validity. c.internal validity. d.st atistical conclusi on validity. ANS: C

Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 232-233

30. Which type of study is considered strongest for testing the effectiveness of an intervention? a.Experimental b.Pretest/Posttest c.Quasi-experimental d.Randomized controlled trial ANS: D Feedback A Experimental designs involve manipulation independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias.

B Pre-test/Post-te st designs are a type of quasi-experimental study design that generally doesnt use random assignment of subjects.

C Quasi-experimental studie s do not have com plete control over variables and usually do not use random assignment of subjects.

D Randomized controlled trials are noted to be the strongest methodology for testing the effectiveness of a treatment due to the elements of the design that limit the potential for bias.

PTS: 1 DIF: Cognitive level: Remembering REF: MCS: 232|MCS: 237|MCS: 238|MCS: 241

31. When using Consolidated Standards for Reporting Trials (CONSORT) guidelines to critically appraise a randomized controlled trial (RCT), the nurse will make sure that the study:

a. is designed to definitively test a hypothesis. b. is conducted in a laborat ory to minimize setting bias. c.use s subjects selected by the researcher for participation. d.uses a descriptive or correlational design.

ANS: A Feedback

ARCTs should be designed to be a definitive test of the hypothesis that the intervention caused the defined dependent variables.

BRCTs should be conducted in a clinical setting and not a laboratory.

CSubjects selected by the researcher may be biased.

DDescriptive or correlational designs are not RCTs.

Chapter 11. Quantitative Methodology: Interventional Designs and Methods MULTIPLE CHOICE

1. Which type of research design focuse s on implementation of a treatment by the researcher? a.Correlational b.De scriptive c.Experimental d.Longitudinal ANS: C Feedback ACorrelational and descriptive designs are nonexperimental studie s that focus on examining variable s as they naturally occur and not on the implementation of a treatment by the researcher.

BCorrelational and de scriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

CQuasi-experimental and experimental studies are designe d to examine causality between a rese archerimplemented treatment and a study outcome.

DLongitudinal design refers to data collection from the same subjects at different points in time and may or may not be used with experimental or nonexperimental studies.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 212

2. A researcher administers a written test to evaluate knowle dge of insulin administration and glucose monitoring to a group of subjects at annual intervals over the next decade. This is an exam ple of which type of study design? a.Correlational b.Cross-sectional c.Descriptive d.Longitudinal

ANS: D Feedback A Correlational studie s see k to ex amine relationships among variable s without manipulation of a treatment by the researcher.

B Cross-sectional de signs examine a group of subjects simultaneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation of variables.

D Longitudinal design refers to data collection from the same subjects at different points intime.

PTS: 1 DIF: Cognitive level: Application REF: MCS: 212

3. A nurse researcher wishes to ide ntify rates of pertussis infection in children less than one year of age and then again at 6 years of age to examine the relationship of immunization status on infection rates in this population. This is an example of which type of study de sign? a.Correlational, longitudinal b.Correlational, cross-sectional c.Descriptive, longitudinal d.Descriptive, cross-sectional ANS: A Feedback AA correlational study design looks at predictive relationships between variable s. A longitudinal study de sign refers to data collection from the same subjects at different points in time.

BCross-sectional de signs examine a group of subjects simult aneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation.

D Cross-sectional designs examine a group of subject s simultaneously in various st ages of de velopment , illness severity, or recovery to identify changes in a phenomenon across st ages. A descriptive study is used to examine variables as they occur naturally without manipulation.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 212

4. Which statement is true about a descriptive study design? a.It is not possible to oper ationally define variable s in this type of study. b.Sam ple selection and size cannot be controlled in descriptive studie s. c.This type of design is used to identify pr oblems occurring in practice. d.Variable s may be manipulated to avoid bias in this type of study.

ANS: C Feedback ADescriptive designs may involve operational definitions of variable s, but variable s are not manipulated in descriptive studies.

BProtection against bias in a descriptive design is achie ved through conceptual and oper ational de finition of variables, sample selection and size, valid and reliable instruments, and dat a collection proce dures that partially control the environment.

CDescriptive designs may be used to develop theories and identify problems with current practice.

DProtection against bias in a de scriptive de sign is achieve d through conceptual and operational definition of variables, sam ple selection and size, valid and reliable instruments, and data collection procedure s that partially control the environment.

PTS: 1 DIF: Cognitive level: Understanding REF: pp. 212-213

5. A nurse conducts a study to see whether there are differences in the number of books Latino parents and the number of books African -American parents read t o their toddlers each week. Which type of study will this researcher utilize? a.Comparative b.Correlational c.Cross-sectional d.Longitudinal

descriptive

ANS: A Feedback A A comparative de scriptive design is used to de scribe variable s and to examine differences in variables in two or m ore groups that occur natur ally in a setting that may have been formed using gender, age, or socioeconomic status.

B A correlational study design looks at predictive relationships between variables.

C Cross-sectional designs examine a group of subject s simult aneously in various st ages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

D Longitudinal design refers to data collection from the same subjects at different points intime.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 216

6. A researcher wishes to conduct a correlational study t o determine whether there is a relationship between stress le vels and relapse rates among patient s who have chronic conditions. In order to determine the existence of a relationship between these two variables, the researcher will attempt to:

a.manipulate the level of stress in study subject s. b.obtain a large range of possible scores. c.provide lengthy descriptions of subjects behavior s. d.randomly assign subjects to study groups.

ANS: B Feedback A Correlational studies do not involve manipulation of a variable.

B In correlational de signs, a large r ange in the variable score s is necessary t o determine the existence of a relationship.

C Providing le ngthy descriptions of subjects behaviors is a necessary part of the discussion of the result s, but it does not determine the existence of a relationship.

D Subject s in correlational studies are not randomly assigned to study groups. PTS: 1 DIF: Cognitive level: Applying REF: MCS: 217

7. If a researcher wishes to describe variables and to examine many relationships in a study, which type of study design will the researcher employ? a.Correlational b.De scriptive c.Descriptive correlational d.Descriptive cross-sectional ANS: C Feedback ACorrelational studie s see k to ex amine relationships among variables without m anipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA de scriptive correlational design is use d to describe variables and examine relationships am ong the se variables. Using this design facilitates the identification of many interrelationships in a situation.

DCross-sectional designs examine a group of subject s simultane ously in various stage s of development, illness severity, or recovery to identify changes in a phenomenon across stages.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 218-220

8. A nurse researcher conducts a study to determine whether women who breastfeed their infant s experience better sleep in the first two postpartum months. This study will employ which type of research design?

a.Correlational b.De scriptive c.Descriptive correlational d.Predictive correlational ANS: D Feedback ACorrelational studie s see k to ex amine relationships among variables without m anipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA de scriptive correlational design is used to describe variable s and examine relationships among these variables.

DA predictive correlational design is use d to predict the value of one variable based on t he values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 220

9. A researcher theorizes a set of relationships among conce pts used t o de scribe why patients with chr onic illness are often depressed. To test the accuracy of these hypothe sized relationships, which type of study will be used? a.De scriptive correlational b.Grounded theory c.Model testing d.Predictive correlational ANS: C Feedback AA de scriptive correlational design is used to describe variables and examine relationships among these variables.

BGrounded theory research is designed to generate theory and to develop new concepts.

CThe model testing design requires all concept s relevant to the model be measured and the relationships among these concepts examined.

DA predictive correlational design is use d to predict the value of one variable based on the values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 221

10. A researcher conduct s a study to ex amine possible contribut ors t o glycemic control in a gr oup of subjects who have type 2 diabetes mellitus in a local community. A convenience sample

of patients includes patients from 28 to 65 ye ars old who r ange in weight from normal to obe se, with time since diagnosis ranging from sever al months to se veral year s. To determine causality in this study, the researcher will: a.discuss outcome s in terms of the pr obability that education will improve glycemic control. b.increase the manipulation of the independent variable to allow greater control by the researcher. c. identify multicausal variables that may influence the outcome of glycemic control measures. d.limit the study to younger persons only to minimize the effects of extraneous variables.

ANS: C Feedback A Probability addre sse s relative and not absolute causality and may be used when given e ffects are not produced consistently.

B In this case, incre asing the manipulation of the inde pendent variable does not alter the influence of multiple causes.

C Multicausality is the presence of multiple cause s for an effect. In this study, patient age, weight, and length of time of diagnosis may all influence the outcome and should be addresse d as fact ors that may alter the results.

D Limiting the study to patients of a certain age only controls for one extraneous variable . PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 223

11. A study in which subjects are assigned by the researcher into experimental and control groups increases: a.bias. b.control. c.manipulation d.validity.

ANS: A Feedback ABias occurs when the attitudes or motivations of the researcher cause a deviat ion from a true measurement of the study variable s. This may occur when researchers control assignment to study groups.

BControl is used to m anage manipulation of variables and to reduce extraneous factor s in the environment that might alter outcomes.

CManipulation of independent variables is used to evaluate changes in dependent variables.

DResearcher control over assignment into groups does not increase a studys validity.

PTS: 1 DIF: Cognitive level: Understanding REF: MCS: 223

12. In a quasi-experimental study examining the effects of nonpharm acologic treatments on postoperative pain m anagement, the researcher trains nur sing staff so that all experimental group subjects receive the same types of treatments. This is an example of: a.bias. b.manipulation. c.reliability. d.validity.

ANS: B Feedback A Bias refers to interference by the researcher that influences the outcome of a study.

B Manipulation is a form of control used in quasi-experimental and experimental studie s and may involve control of the intervention so that it is applied consistently.

C Reliability and validity are related to consistency and trustworthiness of measurement tools.

D Reliability and validity are related to consistency and trustworthiness of measurement tools. PTS: 1 DIF: Cognitive level: Applying REF: MCS: 224

13. A researcher conducts a quasi-experimental study t o determine whether there is appropriate weight gain among premature infant s who are fed according to cue-based pr otocols. The researcher trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d according to cue-based protocols and those fed according to standard protocols. The reviewer critiquing the study notes that not all nurses completed the cue-based feeding module. This would affect which type of validity? a.Construct validity b.External validity c.Internal validity d.Statistical conclusion validity ANS: D Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accur ate reflection of the real world. This can be threatened by anything interfering with consistent implementation of a variable, including inadequate training of individuals who im plement the intervention.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225

14. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infant s who are fed according to cue -based pr otocols. The rese archer trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d accordin g to cue-based protocols and those fed according to st andard protocols. The reviewer notes that components of cue -based feedings are not clearly identified. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: A Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions base d on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

15. A researcher conduct s a quasi-experimental study to determine whether there is improved weight gain among premature infant s who are fed according to cue -based pr otocols. The rese archer trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based

protocols and those fe d according to standard prot ocols. Which might be a threat to internal validity in this study? a.The concept of cue-based feeding is not well defined. b.The study sample is homogeneous. c.Some infants developed gastroenteritis. d.Not all nurses received cue-based protocol education.

ANS: C Feedback AInadequate definitions of constructs are threats to construct validity.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

A study with a more homogenous sample is less likely to have finding s that can be generalized to other populations.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. If not all nur ses received cue-based education, the intervention implementation will be unreliable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

16. A researcher conduct s a quasi-experimental study to determine whether there is improved weight gain among premature infant s who are fed according to cue -based pr otocols. The rese archer trained neonat al intensive care nur ses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fe d according to cue-based protocols and those fed according to st andard protocols. The reviewer notes that parents who gave consent to participate in the study were from a higher socioeconomic class than the population as a whole. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

17. A researcher develops a 7-point Likert scale to evaluate feelings of well -being in patients who are undergoing chemotherapy. The researcher administers this measure to other, similar patients in other medical centers. This is done in order to: a.decrease mono-operation bias. b.improve the test-retest reliability. c.increase interrater reliability. d.strengthen the operational definition of constructs.

ANS: B Feedback AMono-operation bias occurs when only one measure is used to evaluate an outcome.

BTo improve the reliability of the measurement tool, it should be tested in various settings to determine whether it gives consistent measures each time it is used.

CInterrater reliability refers to consistent results that occur when various people administer study measures.

DEvaluating the consistency of a measurement tool does not affect the operational definition of constructs.

PTS: 1 DIF: Cognitive level: Analysis REF: pp. 225-226

18. In a research study, am bulatory clinic nurse s teach children with asthm a how to monitor pe ak expir atory flow volumes and how to use metered-dose inhaler s to determine whether asthma control scores improve.

The researcher discovers inconsistencies in how these measures were taught and how well the children understood the concepts. This represents a lack of: a.control of extraneous variables. b.internal validity. c.intervention fidelity. d.precision of measurement.

ANS: C Feedback

ATo control for extraneous variables, the rese archer would identify characteristics of subjects or settings that might influence outcomes.

BInternal validity looks at the influence of extraneous variables on study outcomes.

CConsistent im plementation of the treatment is referred to as intervention fidelity. If the method of administering a research intervention varies from one person to another, the chance of identifying a true difference based on the independent variables decreases.

DPrecision of measurement refers to whether or not the t ools yield the same readings or findings from one test to another.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226

19. A researcher wishe s to conduct a study of a small number of subjects on a large hospit al intensive care unit. To minimize problems associated with extraneous variable s in the study setting, the researcher will: a.ensure double-blind data collection methods. b.randomly assign subjects to treatment and control groups. c.test the reliability of study measures. d.train a small number of nurses to administer the intervention.

ANS: D Feedback ADouble-blind data collection, r andom assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

BExtraneous variables in complex settings can influence scores on the dependent variable.

CDouble-blind data collection, random assignment of subjects, and reliability of te st measure s are important to improve control and reduce bias.

DOne way to reduce the effect of extraneous variable s is to train a small number of staff to administer the intervention to improve consistency.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

20. A researcher reviews demographic char acteristics of potential study subjects, such as age and gender, to determine whether these characteristics may influence the outcome of the study. This is done to help ensure: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226

21. An important measure to decrease threats to internal validity in an experimental study is to: a.apply the intervention consistently. b.improve the precision of measurement methods. c.increase the sample size. d.randomly assign subjects to study groups.

ANS: D Feedback AConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

BConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

CIncreasing sample size minimizes threats to external validity.

DAn important threat to internal validity is any concern about subject selection and assignment to groups.

Randomly assigning subjects to treatment and control groups helps to minimize thisthreat.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225

22. Which action will the researcher take to improve construct validity? a.Allow data collectors to know which subjects are assigned to which groups b.Ensure that operational definitions reflect theoretical constructs c.Make sure that the rese archer is involved in data collection d.Utilize only one measurement method to measure study variables ANS: B Feedback

A Allowing data collectors to know which subjects are assigned to which gr oups and involving the researcher in data collection both increase the risk of bias.

B Construct validity de pends on adequate definition and measurement of constructs. The conceptual definition should emerge from the concept analysis and the operational definition should cle arly reflect both.

C Allowing data collectors to know which subjects are assigned to which groups and involving the rese archer in data collection both increase the risk of bias.

D Using only one measurement tool increases the risk of mono-operation bias. PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

23. A researcher wishes to study the effects of effective sleep hygiene on sle e p quality and behavior among children diagnosed with attention deficit disorder. To minimize mono-operation bias, the researcher will: a.accurately de scribe conceptual and operational definitions. b.adequately discuss construct validity in the introduction. c.evaluate multiple sleep hygiene techniques. d.utilize a double-blind data collection methodology.

ANS: C Feedback A Construct validity is improved with adequate description of conceptual and operational definitions.

B Construct validity is improved with adequate description of conceptual and operational definitions.

C Mono-operation bias occur s when only one method of measurement is used to assess a construct and can be minimized with the use of multiple measures.

D Use of double-blind data collection methods helps to minimize bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225|MCS: 228

24. Multiple replications of an initial study conducted in different populations produce findings that do not match those in the initial study. The initial study may lack which type of validity? a.Construct validity b.External validity c.Internal validity d.Statistical conclusion validity ANS: B

Feedback AConstruct validity is concerned with the fit between conceptual and operational variable s and require s adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

25. In order to increase participation am ong potential subjects of a lar ger population, the rese archer will: a.limit the time and effort required to participate in the study. b.provide demographic information about those who refuse to participate. c.provide instruments that are detailed to increase the amount of data collected. d.offer potential subjects a financial incentive to participate in the study.

ANS: A Feedback ALimiting the investment demands on subjects helps to improve participation.

BProviding demographic information about those who do not participate is an important part of the discussion of limitations of a study but does not ensure generalization to a larger population.

CDetailed instruments may be time consuming and may limit participation to a small sample size.

DOffering financial incentives does not ensure a sample that is representative of the larger population.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225

26. In order to attribute causality of a posttest measure in an experimental study, the independent variable will be: a.administered to control group subjects only. b.administered to subjects selected by the researcher. c.administered to treatment group subjects. d.define d loosely to avoid bias.

ANS: C

Feedback AThe independent variable is administered to the treatment group and not the control group.

BSelection of subjects by the researcher increases the likelihood of bias.

CTo improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group.

DThe independe nt variable should be precisely define d. PTS: 1 DIF: Cognitive level: Applying REF: pp. 229-230

27. In a study to examine the effects of a newly modified anxiety-reducing nursing action on a group of subjects who have cancer, the control group will receive: a.an alternative intervention. b.no intervention. c.the newly modified intervention. d.the standard intervention.

ANS: D Feedback AAn alternative intervention would invite comparison, but if it is new, it would also beexperimental.

BOffering no intervention is often unethical.

CGiving the newly modified intervention would not create a difference between the treatment and the control groups.

DIn many nur sing studies, offering no intervention (when one exists) to subjects in the control group is considered unethical. Subjects in this group generally receive the standard intervention as a com parison to those in the treatment group.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232

28. In a quasi-experimental study design, the group that receives standard care is usually referredto as the: a.com parison group. b.control group. c.experimental group. d.treatment group.

ANS: A Feedback

AIn a quasi-experimental study, the group that doe s not receive treatment is usually referred to as the comparison group.

BSubjects not receiving treatment in an experimental group are generally referred to as the control group.

CGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

DGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232

29. In a quasi-experimental study using a convenience sample of subjects fr om a local high school, the researcher asks potential subject s to volunteer for placement in either a low sugar diet program or a regular sugar diet program. This technique for assigning participation may compromise: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C Feedback AConstruct validity is concerned with the fit between conce ptual and oper ational variable s and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond thestudy sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 232-233

30. Which type of study is considered strongest for te sting the effectiveness of an intervention? a.Experimental b.Pretest/Posttest c.Quasi-experimental d.Randomized controlle d ANS: D

trial

Feedback A Experimental designs involve manipulation independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias.

B Pre-test/Post-te st designs are a type of quasi-experimental study design that generally doesnt use random assignment of subjects.

C Quasi-experimental studie s do not have com plete control over variables and usually do not use random assignment of subjects.

D Randomized controlled trials are noted to be the strongest methodology for testing the effectiveness of a treatment due to the elements of the design that limit the potential for bias.

PTS: 1 DIF: Cognitive level: Remembering REF: MCS: 232|MCS: 237|MCS: 238|MCS: 241

31. When using Consolidated Standards for Re porting Trials (CONSORT) guidelines to critically appraise a randomized controlled trial (RCT), the nurse will make sure that the study:

a. is designed to definitively test a hypothesis. b. is conducted in a laborat ory to minimize setting bias. c.use s subjects selected by the researcher for participation. d.uses a descriptive or correlational design.

ANS: A Feedback ARCTs should be designed to be a definitive test of the hypothesis that the intervention caused the defined dependent variables.

BRCTs should be conducted in a clinical setting and not a laboratory.

CSubjects selected by the researcher may be biased.

DDescriptive or correlational designs are not RCTs.

Chapter 12. Qualitative Research Methods MULTIPLE CHOICE

1. In addition to the aim or goal of the study, the purpose statement for a qualitative study should include The phenomenon of interest, the population, and the

a. Setting b. Rationale for conducting the study c. Theoretical framework used

d. Hypothesis ANS: A The purpose statement for a qualitative study should include the phenomenon and population being studie d and the setting. The rationale for conducting the study is not included in the purpose statement for qualit ative research. The theoretical framewor k used is not a part of the purpose st atement. Qualitative studies do not use hypothesis statements since stating expected outcomes and relationships are not consistent with the philosophical orientation of this approach. Instead, research questions or objectives are used.

DIF: Cognitive Level: Comprehension REF: MCS: 266

2. In contrast to quantitative research study participants who are selected to be as representative of a population as possible, qualitative research participants are selected because they

a. Are philosophically attuned to the use of narrative s and narrative analysis as the best means to convey their experience to the researcher and to others

b. Meet the requirements for involvement in the study that the researcher specified at the outset of the studys implementation

c. Also are representative of the population d. Have experienced the phenomenon of interest ANS: D The criterion for selecting participant s for a qualitative study is that they have experienced the phenomenon of interest. The participants view of the value of narrative research and analysis is not the reason that study participant s in a qualit ative study are selected. In qualitative methodology, the method of sampling m ay differ as the study progresses, since the researcher may be led to interview a broader range of subjects than originally intended by what early participants relate. Although represe ntativeness of the sample, e specially through random sam pling, is im portant t o external validity (that is, the extent to which the sample s findings can be applied to the population) for quantitative methods, it is not a characteristic of qualitative research.

DIF: Cognitive Level: Comprehension REF: MCS: 267

3. All of the following statements related to sample size are true characteristics of qualitative methodology except for which of the following?

a. The criterion of theoretical sufficiency is used t o determine when the sam ple size is adequate.

b. Samples used in qualitative rese arch are typically much smaller than in quantitative research.

c. The criterion of data saturation is used to determine when the sample size is adequate. d. When asked to indicate in an institutional review board (IRB) proposal how large the sample will be, the qualitative researcher should indicate between 25 and 50 subject s to capture an adequate sample.

ANS: D The text authors recommended including a projected sample size of 12 to 25 participants when submitting a study for IRB approval. The criterion of theoretical sufficiency has been proposed as a means for determining when the sample size is adequate. This refers t o the process where data are collected until the rese arch question can be ade quately addressed. It contrast s with the more establishe d term data saturation as a criterion to determine when the sam ple size is adequate, and is preferred by some researchers who believe that it is more appropriate because one can never com pletely know (or be saturated with) all there is to know about a topic. Sam ples for qualitative rese arch studies are notably sm aller than samples used in quantitative studies.

Data satur ation, or gathering data to the point where one is no longer learning new inform ation about the phenomenon, is a term used to determine when the sample size is adequate.

DIF: Cognitive Level: Analysis REF: MCS: 268

4. The qualit ative researchers awareness of personal biases and past ex periences that might influence his or her responses t o participant s or their dat a so that the data can be hone stly and intellectually analyzed is termed

a. An etic view b. Reflexivity

c. A co-constructive process d. An emic view ANS: B Reflexivity is the term used to describe the researchers awareness of personal biases and past experiences that might influence how he or she responds to the participants and analyzes data in an intellectually honest way. An etic view is one that reflects the outsiders perspective and tends to occur when the qualitative interviewer is not careful about establishing a relationship characterized by openne ss and trust . As a result, the view of the phenomenon obtained by the interviewer is an outsiders perspective . The co-constructive proce ss is a term used to describe the mutual influe nce the qualitative researcher and the study participant have on one another in generating findings. An emic view is the perspective of the participant. Qualitative interviewers should interact with the participant s in a way that is open, fosters trust, and encourage s the emic (or participants) view to emerge.

DIF: Cognitive Level: Comprehension REF: MCS: 268

5. Probing is a strategy used in interviews to a. Make it clear that the interviewer is in charge. b. Limit the range of responses. c. Elicit more information in a specific area. d. Ensure a variety of interpretations of the question by different subjects.

ANS: C In probing, the interviewer asks participant s to elaborate further on a topic through the use of nonthreatening but thought-pr ovoking que stions. Although the questions are controlled by the researcher, the interviewer needs to establish a permissive atmosphere where the participant is encour aged to respond fully and honestly t o the questions asked. Verbally or non-verbally asserting that the interviewer is in charge hinders this proce ss. Structured questions m ay limit the range of responses given by participants, but this is not the purpose of probing. Ensuring a variety of interpretations of the question by different subject s is not the purpose of probing.

Interview questions should be designe d so that each subject s interpretation of the question is as consistent as possible while still encouraging the respondent to answer fully and honestly.

DIF: Cognitive Level: Comprehension REF: MCS: 272

6. A clinical nurse at a large urban hospital has decided to conduct a descriptive qualitative study related to staff nur ses perceptions of the cause s of various type s of violence against nur ses in their facility. As part of his research design, he hosts a series of focus groups with staff nurse s during each of three shifts. What is considered the main advantage of using a focus group strategy as opposed t o one-on-one interviews for data collection?

a. Individuals who are alike on some characteristic are more likely to feel safer or less anxious expressing their views, e specially with difficult experiences, when participating in a focus group rather than in a one-on-one interview.

b. Focus groups allow the researcher to gather a lot of information in a short time. c. Focus groups require less planning than one-on-one interviews do, because interviewers should talk little and listen more.

d. It is more efficient and le ss expensive to transcribe one interview with se veral participants rather than to transcribe several individual interviews.

ANS: A The assum ption underlying focus groups is that in settings that are permissive and non- threatening, participant s are more likely to express and to clarify their views than they would be in individual interviews, especially for sensitive topics. This allows for richer data collection.

Focus groups often generate a great deal of information from the participants perspectives and do so in a short period of time, but this is not the primary advantage of using this data collection strategy. Conducting a focus group involve s a great deal of advance planning to ensure that the interviewer asks relevant que stions in a way that is non-intrusive, non-threatening, and safe . Both one-on-one and focus group interviews require careful planning. Transcribing tapes from both individual and group interviews can be time-consuming and challenging. This, however, is not the primary reason to conduct a focus group about the phenomena of interest instead of a one-on- one interview.

DIF: Cognitive Level: Application REF: MCS: 269

7. What is the typical size and duration of a focus group interview? a. 4 to 12 participants; 3 1/2 hours b. 3 participants; 30 minutes c. At least 12 participants; 3 hours d. 4 to 12 participants; 45 to 90 minutes ANS: D Involving 4 to 12 participants in a discussion that lasts 45 to 90 minutes is typical for focus groups. Four to 12 participant s is considered an appr opriate size for a focus group, although 3 1/2 hours is longer than the typical focus group runs. Three participant s is smaller than the typical number of participants, and a half-hour is less time than is needed to generate a rich discussion of the phenomenon of interest. Involving more than 12 participant s in a focus group may limit hearing the perspective of less vocal members of the group and can be unwieldy. In addition, 3 hours is longer than typical focus groups last.

DIF: Cognitive Level: Knowledge REF: MCS: 278

8. If a researcher decide s to transcribe a recorde d one-hour interview or focus group in order to better understand her data, she might need to spend up to how much time creating a verbatim transcript?

a. 1 hour b. 2 hours c. 4 hours d. 6 hours ANS: D Verbatim transcription of a 1-hour interview or focus group may require up t o 6 hours. DIF: Cognitive Level: Application REF: MCS: 278

9. The role of the facilitator involves all of the following except to

a. Encourage group members to go beyond the current discussion or debate to encourage sharing of perspectives.

b. Instruct participant s that all points of view are valid and helpful and to not ask spe aker s to defend their positions.

c. Prepare for the facilitation experience by developing a few preconceived ide as about the topic in order to direct the discussion most effectively.

d. Reflect on inconsistencies among the views of participants and with their own thinking.

ANS: C Facilitat ors should prepare themselves t o be effective moderators of the discussion, but to not develop preconceived ideas about the topic as this may hinder their ability to hear the perspectives of the group members. Encour aging group members to stretch their thinking and to share their perspectives is the role of an effective facilit ator. It is import ant to instruct group members at the outset of the meeting that all views are valid and helpful t o the rese archer in understanding the topic. Once rapport is est ablished with the group, one of the facilitator s roles is to reflect on inconsistencies among the participants and in their own thinking to challenge ideas and increase group interaction.

DIF: Cognitive Level: Synthesis REF: MCS: 275

10. A researcher is interested in studying the experiences of gay (G), lesbian (L), and transgender (T) youth in the middle school setting. With parental consent and the students assent to participate, she provided a group of 12 student s with disposable digital cameras and had them each take 15 phot os that illustrate their experiences, both positive and negative, as a GLT adole scent. The rese archer then developed the photos and asked participants to discuss what they documented. This is an example of what type of qualitative data collection technique?

a. Thick description b. Photovoice or photo novella c. Participatory research d. Data ANS: B

immersion

Photovoice (or photo novella) is a technique for gathering data from participants that reflect their individual perspectives of a phenomenon. This strategy involves asking individuals to record their experiences and perceptions with photos that are then analyze d for meaning with input from participants. Thick description is a term used to describe a richne ss and dept h of information gathered fr om effective qualitative interviews.

Involving study participant s in collecting dat a via taking digital photogr aphs would be a participatory strategy but is not specific term for this technique. Data immersion is a term commonly used to de scribe the researchers experience of being immersed and fully invested in reading and thinking about the data.

DIF: Cognitive Level: Analysis REF: MCS: 277

11. The primary disadvantage to the use of Internet-based data collection is that a. It can be difficult to obtain consent. b. It limits the sample to those who can read and write, use computers, and have Internet access.

c. It can only be used with quantitative research methods. d. The subject pool tends to be limited.

ANS: B The main disadvantage of Internet-base d dat a collection has to do with sam pling those who are able to read and write, are computer-literate, and who have Internet access. Thus, the poorly educated, elderly, disable d, or disadvantage d may be underrepresented. Researcher s who conduct Internet-base d research are often able to obtain consent by noting a statement like Completion and submission of the survey implies consent. Dat a can be effectively collected for a qualit ative study using the Internet. Although there are some sam pling limitations in terms of certain populations, the subject pool in general tends to be very large given the extensivene ss of the online community not limited by geographic space.

DIF: Cognitive Level: Analysis REF: MCS: 277

12. In addition t o sample bias and ethical issue s (e.g., securing consent, assuring anonymity, and protecting site security), a third concern about factor s that may affect the credibility of Internet - mediated study findings is

a. The interviewers ability to establish rapport with study participants b. The fact that use of a pseudonym might cause participants t o make up information about the phenomenon

c. The researchers ability to transcribe the data gathered through online interviews d. Reliability and validity of dat a, although terms most often applied to quantit ative research, might be an issue since the rese archer cant verify whether or not participants meet inclusion criteria for the study ANS: D Not being able t o ensure that participant s meet inclusion criteria and being unable t o control distractions during data collection are the biggest thre ats t o the validity and reliability of the rese arch findings gathered

by Internet-mediated data collection. A skilled and personable interviewer may be able to establish good rapport and to effectively conduct online interviews with study participants. Use of a pseudonym, as well as site controls, helps ensure that participants identities are not made public. Plans t o care fully capture interviews digitally, note- taking, and careful data transcription minimize problems with transcription of data.

DIF: Cognitive Level: Analysis REF: MCS: 278 MULTIPLE RESPONSE

1. Which of the following st atements are true statements about qualitative research methodology? (Select all that apply.)

a. Qualitative researcher s develop que stions and then determine which philosophical appr oach to use to answer the question.

b. Qualitative analyses involve using words rather than numbers as the basis of analysis. c. Because the methods used for sam pling, data gathering, and analysis are more flexible for qualitative research than for quantitative research, qualitative research is considered a less rigorous approach to nursing research.

d. As with quantitative research, qualitative researchers are not able to modify sampling and data gathering proce sse s once the study begins, since this leads to problems with internal validity.

ANS: A, B Qualitative researcher s typically first do a literature search and develop their research question and then determine which philosophical approach (e.g., ethnography, phenomenology) needs t o be used to address the research question. Note that some qualitative researchers will defer the review of literature until after data collection to avoid biasing their an alysis and dat a interpretation. In qualitative rese arch, narratives (transcriptions of respondents stories about their experiences) and written observations are analyzed for themes and patterns. Although strict positivist s would argue that qualitative methodology is le ss rigor ous than quantitative approaches to research, most nursing researcher s believe that qualitative research employs the same careful skills in analytical reasoning and is as rigorous in seeking knowledge about human experience.

Internal validity is not a criteria applied t o qualitative re search. In qualitative approaches, data analysis begins as data are gathered and insights may suggest the need to modify the original methodology. Such changes, however, need to be supported with a clear rationale.

DIF: Cognitive Level: Synthesis REF: MCS: 264

2. Which of the following are true statements regarding data analysis in qualitative research? (Select all that apply.)

a. Qualitative dat a analysis involves examining and interpreting dat a in or der to elicit meaning, gain understanding, and develop empirical knowledge.

b. Although qualitative data analysis m ay identify additional dat a that may need to be collected, once the data collection period is over, the rese archer is discour aged from going back to participants to gather additional information.

c. Data analysis in qualitative research occurs concurrently with data collection. d. Researchers are encour aged to dwell with the data by immersing themselves in transcripts, tapes, and interview notes to make sense not only of what participants have said but also of meanings underlying expressions, emphasis, and nonverbal communications.

ANS: A, C, D The purpose of qualitative dat a analysis is to ex amine and interpret data to elicit meaning and understanding t o add to the professions body of knowledge. Data analysis occurs concurrently with dat a collection. Researchers must immerse themselves with the data to obtain the deepest

understanding possible of the phenomenon being inve stigated. As long as the qualitative rese archer has additional que stions, he or she has not reached data saturation; going back to participant s to gather additional information to clarify meanings is expected.

DIF: Cognitive Level: Synthesis REF: MCS: 266

3. Which of the following are accurate st atements about the interview process use d by qualitative rese archers?

(Select all that apply.)

a. It is sufficient to de velop interviewing skills once the interviewing of study participants begins since the qualit ative research proce ss involves co-construction of data; learning to interview is part of the proce ss the rese archer is expected to experience once data collection begins so that the interviewer enters the study without bias or preconceived ideas.

b. When participants appe ar to begin speaking about a subject that seems unrelated to the focus of the study, an effective strategy is to ask obtain the respondent s perspective by asking how the new subject is related to his/her previous comments.

c. The interviewer should dress in either business attire or a nur sing uniform when conducing interviews or focus groups.

d. When a study participant appear s to be fatigued or in pain from illness or treatments, the interviewer should offer to stop the interview, t o take a break, or to reschedule for another day.

ANS: B, D When the interviewer doe s not underst and how a topic might be related to the t opic being discusse d, it is an effective strategy to obtain the participant s perspective; then, if there still appe ars to be no link, the interviewer can redirect the interview. The interviewer must not inflict unnecessary harm upon participants.

Even though interviews are not generally considered invasive, they may be invasive to the psyche.

Researchers who have less experience with interviewing should work to develop interview skills before they start interviewing study participants, since interviewing is a skill t hat directly affects the quality of the dat a produced. It is generally not a good ide a for the interviewer to dress for an interview in business attire or a nursing uniform since this may em phasize power differences in the relationship. Interviewers should consider how the participant is likely to be dressed and select their own clothing accordingly.

Chapter 13. Outcomes Research MULTIPLE CHOICE

1. The goal of outcomes research is to: a.determine the most cost-effective nursing interventions in patient care. b.examine the end results of patient care from various health interventions. c.help pr oviders make end-of-life decisions about patient care. d.improve patient satisfaction with nursing care.

ANS: B Feedback A Cost-effectiveness is one possible outcome, but other patient outcomes may be more important.

B Outcomes research focuses on the end results of health care practices and interventions.

C Outcomes rese arch is not solely about end-of-life care and is not focused on end-of-life decision making.

D Patient satisfaction is one re sult but is not the goal of all outcomes research. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 467

2. What is the key construct in Donabedians theory of outcomes research? a.Efficiency of health care delivery b.He althy outcomes c.Profe ssional accountability d.Quality of care ANS: D Feedback AEfficiency, he althy outcomes, and professional accountability all m ay be ex amined during outcomes research, but none of these is the key construct.

BEfficiency, healthy outcomes, and professional accountability all m ay be examined during outcomes research, but none of these is the key construct.

CEfficiency, he althy outcome s, and professional accountability all may be examined during outcome s research, but none of these is the key construct.

DQuality of care is the overriding construct of Donabedians theory of outcomes research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp.

468-469

3. Which is an example of a type of nursing service that might be evaluated in outcomes research? a.Application of wound care products b.Clinical care protocol implementation c.Glucose monitoring for newly diagnosed diabetics d.Using a Braden Scale for skin assessment ANS: B Feedback AApplication of product s, monitoring patient status, and using me asurement scales are all exam ples of nursing interventions.

BNursing service s can include st affing and education of nurses as well as implementation of protocols and standards of care.

CApplication of product s, m onitoring patient st atus, and using measurement scales are all exam ples of nursing interventions.

DApplication of products, m onitoring patient status, and using me asurement scales are all exam ples of nursing interventions.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp.

468-469

4. Which would be an example of an interdependent role for nurses in the Nursing Role and Effectiveness Model? a.Administering a medication t o a patient b.Arranging for home health care service s c.Initiating a fall risk prot ocol d.Performing an admission assessment ANS: B Feedback ADependent role functions include execution of medical orders and physician-initiated treatments.

BInterdependent role functions in the Nursing Role Effectiveness Model include communication, case management, and coordination of care.

CDependent role functions include execution of medical orders and physician-initiated treatments.

DIndependent role functions include assessment, diagnosis, and nursing-initiated treatments.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 469-470

5. In an outcome study, a researcher demonstrates a link between the number of mothers who successfully breastfeed their infant s and the number of maternal-child nurse s who are baccalaureate prepared. This illustrates:

a. interdependent nursing role functions. b.nursing-sensitive patient outcomes. c.patient-sensitive outcomes. d.the Nursing Role Effectiveness Model.

ANS: B Feedback AInterdependent nursing functions are those that include both nurse-initiated and physician- initiated treatments.

BOutcomes that are nur sing sensitive are those that are influenced by nur sing care decisions and actions as well as those associated with nursing staffing, education, and assignments.

CPatient-sensitive outcomes are those that are influenced by different aspects of patients, such as age, gender, or disease process.

DThe Nursing Role Effectivene ss Model examines outcomes that are nursing sensitive.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 471-472

6. The development of the Uniform Hospital Discharge Data Set and the Universal Minimum Health Data Set was helped by: a.establishing guidelines for outcomes research. b.identifying the contribution of nursing care t o patient outcome s. c.prescribing data elements to be monitored in outcomes rese arch. d.reporting financial and statistical data from hospitals.

ANS: C Feedback AThe data sets helped facilitate standards about dat a elements but did not est ablish guideline s for outcome s research.

BThe Nursing Role Effectivene ss Model helped to identify the contribution of nursing care to patient outcomes.

CThe data sets facilitated consistency in data collection am ong he alth care organizations by prescribing the data elements to be gathered.

DThe Canadian Institute for He alth Information e stablished a reporting system to report financial and statistical data from hospitals.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 472

7. Which government agency supports research to improve the outcomes and quality of health care? a. AHRQ b.ARRA c.CIHI d.FDA ANS: A Feedback AThe Agency of He althcare Rese arch and Quality (AHRQ) supports research designe d to improve the outcomes and quality of health care.

BThe American Recovery and Reinve stment Act (ARRA) is not a government agency; funding from this act allowed AHRQ to expand its work in support of comparative effectiveness research.

CThe Canadian Institute for Health Information (CIHI) helped to est ablish national Canadian standards for collecting and reporting financial and statistical data from health service organizations.

DThe Federal Drug Administration (FDA) regulates the research and distribution of medications. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 472

8. Which organization include s nursing-sensitive outcomes measures in its performance measurement portfolio? a.Agency of Healt hcare Re search and Quality b.De partment of He alth and Hum an Services c.National Guideline Clearinghouse d.National Quality Forum ANS: D Feedback AThe Agency of Healthcare Research and Quality supports research designed to improve the outcomes and quality of health care.

BThe Department of Health and Human Services includes the Agency of Healthcare Research and Design.

CThe National Guideline Clearinghouse is a resource for evidence-based guidelines.

DThe National Quality Forum was created as a national st andard-setting organization for health care performance measures and includes nursing-sensitive measures in its portfolio.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 474

9. The National Quality Forum was established in 1999 for which purpose? a.To identify and develop nursing-sensitive quality measures b.To support state and health system efforts to implement and evaluate medical liability reform models c.To allow the AHRQ to expand its work supporting comparative e ffectivene ss rese arch d.To set standards for health care performance measures ANS: D Feedback AThe NDNQI identifies and develops nursing-sensitive quality measures.

BThe AHRQ supports state and he alth system efforts to implement and evaluate medical liability reform models.

CThe ARRA allows the AHRQ to expand its work supporting comparative effectiveness research.

DThe National Quality Forum sets st andards for health care perform ance measure s. PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 474

10. To help meet the requirements for Magnet recognition, which organization will a hospital participate in? a.The American Nurses Association (ANA) b.The Agency of He althcare Research and Quality (AHRQ) c.The National Database of Nursing Quality Indicator s (NDNQI) d.The National Quality Forum (NQF) ANS: C Feedback AAlthough the ANA is the organization that over sees the Magnet Recognition Progr am, hospitals do not join this organization.

BThe AHRQ supports research designed to improve the outcomes and quality of health care.

CParticipation in NDNQI meets requirements for the Magnet Recognition Program.

DThe NQF was created as a national standard-setting organization for health care performance measures.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

474-475

11. Which is one of the indicators used by the National Database of Nursing Quality Indicators (NDNQI)? a.Asse ssment, intervention, and reasse ssment of pediatric pain b.Clinical Laboratory Improvement Amendment (CLIA) standards c.Pr otocols for monitoring biometric equipment used in hospit als d.The number of hour s hospital residents work per week ANS: A Feedback ANDNQI identifie s and develops nur sing-sensitive quality me asure s. Asse ssment , intervention, and reassessment of pediatric pain is one of the indicators it uses.

BCLIA standards are those applied to hospital laboratory personnel and equipment.

CBiometric equipment standards are not nursing-sensitive measures.

DStandards about hospital resident s are not nursing -sensitive measures. PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: pp. 474-475

12. Which is an important finding in outcomes research about Advanced Practice Nursing (APN)practice? a.APNs provide care that is equivalent to that provided by doctors at a fraction of the cost. b.Care by APNs shows equivalent or improved outcomes to that provide d by physicians. c.Hospital readmission rates are slightly higher for patient s who use APNs for primary care. d.The level of patient satisfaction is greater with APNs regardless of clinical outcomes.

ANS: B Feedback AStudies are not reported showing equivalent care at reduced cost.

BThere is abundant research demonstrating the safety and e ffectivene ss of APNs. In a se arch of all random controlled trials comparing APNs to usual care, findings consistently showed that care by APNs resulted in equivalent or improved outcomes.

CStudies do not show increased readmission rates.

DPatient satisfaction is high, but so are positive clinical outcomes. PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 476-477

13. What is an important aspect of outcomes research as defined by Donabedian? a.Selection of only proximal outcome s in order to streamline outcomes research b.The need for patients or recipients of care to define which outcomes are de sirable c.T he need to link outcomes with specific nursing processes d.The use of population groups rather than individuals for outcome studies ANS: C Feedback AOutcomes research involves studies of all outcomes of nursing care.

BDonabedian does not identify the need to study patient feelings about outcomes or care.

CIn outcome s rese arch, according to Donabedian, there is a need t o clearly link identified outcomes with the processes that caused the outcomes.

DDonabedian does not identify the need to use population groups rather than individuals for outcome studies.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

REF: MCS: 477

14. Which is an example of a distal outcome in outcomes research? a.Glucose monit oring skills in patients receiving diabetic teaching b.Hospit al readmission rates in patients admitted for myocardial infarction c.Pain scores be fore and after pain medication d.Patient perception of tobacco advertising among COPD patients ANS: D Feedback AGlucose monitoring skills, hospit al readmission rates, and pain score s are proximal outcomes because they are related directly to nursing interventions and not to external forces.

BGlucose monitoring skills, hospital readmission rate s, and pain score s are proximal outcome s because they are related directly to nursing interventions and not to external forces.

CGlucose monitoring skills, hospital readmission rates, and pain scores are proximal outcome s because they are related directly to nursing interventions and not to external forces.

DA distal outcome is one which is remove d from pr oximity to the care or service received and is m ore influenced by external (nontreatment) factors. Quality of life is an example of a distal outcome.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 478

15. In outcomes research, a Magnet-designated hospital is an example of which type of variable? a.De pendent b.Intervention c.Outcome d.Structural ANS: D Feedback AA dependent variable is one that is affected by manipulation of another variable.

BAn intervention variable is one that is manipulated to examine the effects of this m anipulation on a dependent variable.

CAn outcome variable is one that is linked to patient care.

DMagnet designation indicates certain standards of structure including shared governance, implementation of nursing practice, and autonomy.

PTS: 1 DIF: Cognitive level: Under standing (Comprehension) REF: pp.

478-479

16. A nurse use s a care map to guide nursing interventions for patients with COPD. This is an example of using: a.evidence-based practice. b.practice patterns. c.practice styles. d.standards of care.

ANS: D Feedback AEvidence-based practice include s clinical guidelines, critical paths, and standards of care. BA pr actice pattern is a conce pt representing the variation in what type of care is provided. CA practice style represents variation in how care is provided.

DA st andard of care is a norm according to which quality of care is judge d and include s guideline s, critical paths, and care maps.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

480-481

17. What is the role of evidence-based practice in outcomes research? a. Evidence-based practice identifies practice standards that can be evaluated using patient outcomes. b. Evidence-base d practice defines practice styles and patterns used in professional practice. c.The standards used in evidence-based pr actice clearly identify de sired patient outcomes. d.There is a clear link between evidence-based practice and improved patient outcomes.

ANS: A Feedback AEBP guidelines contain standards and norms against which patient outcomes can be evaluated.

BPractice styles and patterns represent variations in what type of care and how care is delivered and are part of clinical guidelines.

CVery few empirical studies have assessed the impact of EBP on patient outcomes.

DVery few empirical studies have assessed the impact of EBP on patient outcomes.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

480-481

18. What type of sample is generally used in outcomes studies? a.Small sample b.Heterogene ous sample c.Homogeneous sample d.Volunteer sample ANS: B Feedback AA small sample would not provide a heterogeneous sample.

BBecause the target population in outcomes studie s is often heterogene ous, it is nece ssary to obtain large, heterogeneous samples.

CTypical sam pling criteria for outcomes re search include obt aining a very large, heterogene ous sample in which all patients have the likelihood of being represented.

DA volunteer sample is generally not encouraged, as it does not allow for the rese archer to influence the sample characteristics.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

481-482

19. Which type of study design is commonly used in outcomes studies? a.Phenomenological b.Qualitative c.Quasi-experimental d.Random-control trial ANS: C Feedback APhenomenological and qualitative studies do not account for effects of variables on patient outcomes.

BPhenomenological and qualitative studies do not account for effects of variables on patient outcomes.

CQuasi-experimental studie s and observational research designs are most commonly used for outcome s research to provide effectiveness and efficiency.

DRandom controlled trieals also seek to provide evidence about the effects interventions, but, with outcomes studies, the intervention is not limited to medications or clinical procedures..

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp.

483-484

20. A researcher identifies a group of Native American subjects who are at risk for type 2 diabetes mellitus and follows this group over time to observe actual rates of acquiring this dise ase . This is an example of a: a.clinical database . b.prospective cohort study. c.qualitative study. d.quasi-experimental study.

ANS: B Feedback AA clinical database is a collection of data about a group of patients.

BA prospective cohort study is an epidemiologic study in which the researcher identifies a group of people who are at risk for a condition and follows them over time.

CA qualitative study is a nonexperimental study to examine attributes of a group of subjects.

DA quasi-experimental study is one in which the researcher has less control over independent variable s than in a random controlled trial.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

484-485

21. A nurse identifies an unusual incidence of acute lymphocytic leukemia (ALL) in school-age children in a nearby community and conduct s a study to examine exposure to a variety of water pollut ants from a local industry. This is an example of a: a.phenomenological study. b.qualitative study. c.prospective cohort study. d.retrospective cohort study.

ANS: D Feedback

AQualit ative and phenomenological studie s are nonexperimental studies to examine attributes of groups of subjects.

BQualitative and phenomenological studies are nonexperimental studie s to examine attributes of gr oups of subjects.

CA prospective cohort study is an epidemiologic study in which the researcher identifie s a gr oup of pe ople who are at risk for a condition and follows them over time.

DA retrospective cohort study is an epidemiologic study in which the researcher identifies a group of people who have experienced a particular event and examines possible previous causes for this event.

PTS:1DIF:Cognitive le vel: Applying (Application) REF: pp.

485-486

22. A researcher wishe s to widely disseminate findings of outcomes research in order to influence practice in a variety of settings. Which methods might this researcher use? a.A series of present ations and publications in profe ssional and public forum s b.An oral presentation at an international conference c.Publication in scholarly, peer-reviewed journals d.Writing about this research in a chapter of a nursing textbook ANS: A Feedback AEmploying a series of present ations and publications in many ve nues is the only approach that achieve s a widespread dissemination of the research findings.

BAn open forum for exchange of ideas is excellent but is not sufficient in the eyes of outcomes researchers.

Outcomes rese archers consider wide dissemination of the results to provider s and consumers necessary to promote change in health care practices.

CPresenting the findings, even at a prestigious conference, is not sufficient in the eye s of outcome s researchers. Outcomes rese archers consider wide dissemination of the results t o providers and consumers necessary to promote change in health care practices.

DOutcome s researchers consider wide dissemination of the results t o providers and consumers necessary to promote change in health care practices.

Chapter 14. Mixed Methods Research MULTIPLE CHOICE 1. Which method will a researcher use to evaluate a group of qualitative studies?

a.

Meta-analysis

b.

Meta-synthesis

c.

Mixed-methods systematic review

d.

Systematic review

ANS: B

Feedback A meta-analysis is a review of quantitative studies by statistically pooling or com bining the results from these studies into a single quantitative analysis.

A A meta-synthesis is used to pool and combine findings from qualitative studies.

B

C

A mixed-methods system atic review is used to evaluate a com bination of quantitative and qualitative studies.

A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice.

D 2. A researcher evaluates data from a variety of studies, including those involving qualitative and quantitative research, and use s findings from qualitative studie s to interpret synthesized quantitative studies. This is an example of: a.

meta-synthesis.

b.

mixed-method synthesis.

c.

multilevel synthesis.

d.

parallel synthesis.

ANS: D

Feedback

A meta-synthesis is used to pool and combine findings from qualitative studies.

A A mixed-methods synthesis review is used to evaluate a combination of quantitative and qualitative studies.

B A multilevel synthesis involve s synthesizing the findings from quantitative studies separately from qualitative studies and integrating the findings in the report.

C Parallel synthesis involves the separate synthe sis of quantitative and qualitative studie s, but the findings fr om the qualitative synthe sis are used in interpreting the synthesized quantitative studies.

D

3. Intervention research shifts the focus from causal connection to causal explanation. What does this mean? a.

It allows correlational research determining connection to st and in the place of causal explanation.

b. It provides theoretical explanations of why an indepe ndent variable pr oduce s an e ffect, rather than merely reporting findings. c.

It may use studies that est ablish causal connection as impetus point s, but it proceeds on to descriptive research whenever possible, to explain.

d. It utilizes experimental research, whenever possible , to establish cause definitively.

ANS: B Intervention research is a methodology that holds great promise as a more effective way of testing interventions. It shifts the focus from causal connection to causal explanation. In causal connection, the focus of a study is to provide evidence that the intervention contributes to the outcome. In causal explanation, in addition to demonstrating that the intervention causes the outcome, the researcher must provide scientific evidence to explain why the intervention contributes to changes in outcomes and how it doe s so. Causal explanation is the ory based. Thus, rese arch focuse d on causal explanation is guide d by the ory, and the findings are expressed

theoretically (see Chapter 7). Rese archers employ a broad base of methodologies, including qualitative studies, to examine the effective ness of an intervention. Qualitative appr oache s offer substantial value to the development, feasibility, and validation of nursing interventions.

4. Why may intervention research involve the efforts of an entire project team? a.

A multidisciplinary team provide s the grounding, objectivity, and world wisdom t o judge whether an intervention really has clinical merit.

b. Each member of the team carries out a separate research project at a different site, so that the results can be multi-site and more readily generalizable. c.

Institutional review boards will not appr ove intervention projects unle ss they are backed by an entire team, including representatives from both nursing and medicine.

d. It is rare for one person to be im aginative, clinically current, expert at marketing, skilled in statistics, and adept at both quantitative and qualitative research.

ANS: D Because of the nature of intervention re search, one m ay need to gather a multidisciplinary project team to facilitate distribution of the work and a broader generation of ideas. If both quantitative and qualitative data will be gathered during the rese arch project, the team should include members experienced in various qualitative and quantitative data collection and analysis approache s. Including a te am member with marketing expertise will be beneficial, because the final step of the project will be to market the intervention.

5. The presence of drop-down oxygen masks on airplane s represents the process of intervention research.

During their development, a prototype was designe d and refined. What was the final stage of the testing process for drop-down oxygen masks? a.

Testing of oxygen masks was initiated on several actual consumer airline flights.

b. An analysis was made of all notes made by the intervention team during meetings. c.

Oxygen masks already in use on commercial airlines were revised, according to the original protocol specifications.

d. Oxygen masks were tested in labs on human volunteers.

ANS: A Advanced testing of the intervention occurs after sufficient evidence is available that the intervention is effective in achie ving the desired outcomes. The model proposed by For bes (2009) place s this type of testing in phases III and IV, where the intervention is compared to st andard of care interventions followed by replication studies with long-term follow-up of the interventions effectivene ss. Stage III of intervention testing might involve a single, well- designed study that indicate s a satisfactory ES for an intervention, but often an intervention requires modification through additional studie s. Replication studie s ensure that an interventionis refined to create the desired effect in practice.

6. Why is treatment fidelity such a major concern in intervention research? a.

If treatment fidelity is not maint ained, it has a direct influence on st atistical conclusion validity and power analysis, especially when samples are large.

b. The project team may differ about how an intervention is applied, and the se varying ways of application must be discussed before marketing can occur. c.

Intervention research can take place over many months. It is important for internal validity that the intervention be applied in the same way every time.

d. Interventions, especially those involving product s that are centered in the health care realm, must reflect the ethical standards of the profession.

ANS: C Treatment fidelity has to do with the accuracy, consistency, and thoroughness in how an intervention is delivered according to the specified pr otocol, treatment program, or intervention model. Strict adherence to treatment specifications must be evaluated on an ongoing basis during the course of a study. Intervention fidelity is defined as the adherent and com petent delivery of an intervention by the interventionist as set forth in the research plan, and this fidelity is of utmost importance to the inference of the studys internal validity in intervention-based rese arch. Treatment fidelity is important in the conduct of all intervention-base d research, but it is especially critical for com plex interventions such as those involving information dissemination, social support, counseling, and other interventions intende d to bring about change s in health be haviors and psychosocial outcomes.

7. In the process of interventional rese arch on the efficacy of omega 3 fish oil in decreasing blood sugar in diabetic adults, which event would appear just before widespread dissemination? a.

A randomized clinical trial testing the effects of omega 3 fish oil on blood sugar in 300 ambulatory diabetic adults

b. Proof of the safety of the prescribed dose of omega 3 fish oil c.

Several replication studie s of the effects of omega 3 fish oil on blood sugar in hundreds of ambulatory diabetic adults

d. Efficacy studies to establish outcome e ffects of omega 3 fish oil and optimal treatment regimens in adults ANS: C Theory-based intervention research can begin with a conce pt analysis of the problem or the intervention intended to address it. By dissecting the components of problem s and plausible solutions, investigators can gain clarity of the issues at hand. After pre-clinical work, proof of the safety of an intervention and estimate s of effect occur; following that are efficacy studie s to est ablish outcome effect s and optimal treatment conditions.

Then a randomized controlled trial is conducted. This is followed by replication and/or long-term follow-up.

8. A research pr oject shows that a new intervention involving hypnosis decreases PTSD dr amatically in servicemen returning from the Middle East. Thirty-three percent of men and women so treated are functional in daily living and free from symptom s three weeks after treatment. Twenty percent of men and women treated remain free from symptom s at one ye ar. Calculate the number s needed to treat (NNT), both at three weeks and at a year. a.

The NNT at three weeks is 0.33; the NNT at one year is 0.20.

b. The NNT at three weeks is 1; the NNT at one year is 1. c.

The NNT at three weeks is 33; the NNT at one year is 20.

d. The NNT at three weeks is 3; the NNT at one year is 5.

ANS: D Numbers needed to treat (NNT) is a metric that is defined as the number of patients who would need to be treated with the new intervention to avoid one event that might have occurred with

standard treatment. It is necessary that NNT be estimated in the context of those deriving a bene fit or those who might be harmed by the intervention (Day, 2007). Intuitively, it is an easy concept to grasp as it is expressed in a numeric value. For example, if the NNT is 4 for a benefit from an intervention, then a prescriber of intervention could expect that 1 out of 4 patients treated with the intervention would derive a positive outcome. The NNT is determined by an analysis of the data following the completion of an adequately powered study (e.g., the sam ple size is ade quate) to detect treatment differences. The rese archer establishe s criteria for the primary outcome measure for the study that is indicative of a positive or undesirable response, and the NNT is expressed in terms of either outcome. Researchers are often required to calculate the NNT for clinical trials prior to submitting a manuscript for publication to influential research journals. NNT are often poole d and analyzed in meta-analyses and systematic reviews of studies. Moreover, it is a me aningful parameter for practice, as clinicians can be informed of the overall effectiveness of the intervention, as well as the expected response when prescribing an intervention. When interpreting NNT, it is important to determine if the NNT value is for a single administration of the intervention, at a single time point, or overall across multiple time points.

9. Blinding to treatment involves not letting the patient know which intervention is being delivered. If the research subject who exercises daily because he is in the treatment group knows which treatment is being delivered, but the researcher and the research staff do not know, what type of condition exists? a.

Single blinding

b. Double blinding c.

Triple blinding

d. Unilateral unblinding ANS: A With single-blinded studies, there are two variations. In one variation, study participants are not aware of their treatment assignment but investigator s and research st aff may have knowledge of who is in what group. The reverse may be used when participant s have knowledge of their treatment group assignment but this information is not available to the investigators and research st aff. For example, children involve d in research comparing the calming effects of music alone

compared to music with mothers voice delivered by audiotaped recordings would recognize the contents of the tape if they were alert. Rese archers and dat a collector s may not be told of participant gr oup assignment.

Double-blinded studie s keep knowledge of study conditions fr om study participant s, investigators, and research staff. When a study is triple-blinde d, the participant s, rese archers, and those involved in data management are unaware of group assignment.

10. The project team in intervention re search failed t o operationally define the study variables correctly.

Which subsequent actions of the team were affected? (Select all that apply.) a.

The research question posed failed to address the problem accurately.

b. Results were not meaningful to clinicians. c.

The methods used to study the problem were inappropriate for intervention research.

d. The results could not be discussed effectively, in terms of the hypotheses. e. A type III error was not avoided.

ANS: A, B, D, E The initial focus of the team is to clarify the problem or issue of interest. The pr oject team must be alert to the risk of m aking a type III error. A type III error involves asking the wrong questiona que stion that does not address the problem of concern. This error is most likely to occur when the researchers do not thoroughly analyze the pr oblem and, as a re sult, have a fuzzy or inaccur ate underst anding of the issue of concern. The solution, then, does not fit the problem . A study conducted on the basis of a type III error provides the right answer to the wrong que stion, leading to the incorrect conclusion that the newly designed intervention will resolve the problem. .11. A nurse is developing a prototype for a new product that allows a very close approximation of blood sugar , based on 2 ml of filtered saliva. Which of the following per sons should be included in the project team?

(Select all that apply.)

a. A biost atistician who will perform the calculations that will convert saliva glucose values to blood glucose equivalents

b. An endocrinologist who will order the insulin based on the reported values c. Working nurses who will be collecting the saliva samples d. Lab technicians who will not be analyzing blood glucose values any longer after the new method is in place

e. Patients who will have their saliva tested f. The nurse who is developing the prototype ANS: A, B, C, F Because an intervention research project often involves a study extended over a period of time, sometimes years, nur se researchers are advised to give careful thought to the composition of their research teams.

Researchers need to determine (1) who will be included on the project team, (2) what level of expertise is required for team members, (3) how team members will function together, and (4) the roles team members will assume. Because of the nature of intervention re search, a multidisciplinary project team will facilitate distribution of the work and a broader generation of ideas. If both quantitative and qualitative data will be gathered during the research project, your team should include members experienced in various qualitative and quantitative data collection and analysis approaches.

12. Why is the process of revision of BLS standar ds from Airway-Breathing-Circulation to CirculationAirway-Breathing considered intervention research? (Select all that apply.)

a. It is grounded in theory. b. It started qualitatively with ideas and observations about the reasons patients code. c. It was field-tested and then researched using randomized clinical trials. d. The findings were replicated in multiple settings. e. It was initiated by a nurse. f. It emanates from previous research on CPR and its outcomes.

ANS: A, B, C, D, F Project team tasks include gathering initial information, developing an intervention theory, designing the intervention, field-testing the intervention, analyzing results, testing the

intervention, using a randomize d controlled trial, collecting and analyzing data, replicating the results, and disseminating the intervention. Qualit ative research may be used if researcher s are in the initial phase of developing a model or prototype for an intervention.

Chapter 15. Sampling MULTIPLE CHOICE

1. A researcher is studying sleep habit s of household cats that belong to families with sm all children. The families live in urban areas. In this study, what are the elements?

a. Small children b. Household cats c. Families d. Sleep ANS: B The individual units of the population and sam ple are called elements. The elements are the things the researcher studies. An element can be a person, event, behavior, or any other single unit of study. In this case , the researcher is studying catsnot children, not families, and not sleep.

DIF: Cognitive Level: Analysis REF: MCS: 352

2. A researcher wants to incre ase the generalizability of a planned experimental studys re sults. What can the researcher do, relative to sampling, that will achieve that goal?

a. Select a sample larger than that recommended by power analysis. b. Purposively select a sample that is extremely heterogeneous. c. Use random assignment. d. Use random sampling.

ANS: D

Random sam pling increases the extent to which the sample is represent ative of the target population. Good representativeness enhances generalizability of the results. Selecting a sam ple larger than the size recommended by power analysis results only is a larger sample, not a more representative one. Purposive selection of a more heterogeneous sample does not increase the sam ples representativene ss. Use of random assignment has no effect on representativeness of thesample, since it is selected before assignment occurs.

DIF: Cognitive Level: Analysis REF: MCS: 357

3. A researcher studies spending habit s of teenagers in strip malls. From what kind of population has the researcher selected her sample?

a. The accessible population b. The entire population c. The target population d. The target sample ANS: A An accessible population is the portion of the target population to which the researcher has reasonable access. The sample is obtained from the accessible population by a particular sampling method. The t arget population is the entire set of individuals or elements who meet the sampling criteria. The sample is selected from the accessible population within the target population, since this is the population from which the researcher can actually select subjects.

The sample here is a subset of the accessible population that actually checks into shelters, not the t arget population of all homeless persons. The entire population is a particular group of pe ople who share one or more characteristics that are the focus of the research.

DIF: Cognitive Level: Application REF: MCS: 351

4. A researcher selects his sam ple in this way. He paints numbers on 100 ping-pong balls, and he paint s half of them blue and half of them green. He puts the blue half onto a large tray, and the green half of them ont o another large tray. The n he mixes e ach gr oup and trains his dog to bring 10 balls from each tray t o him, gently and systematically, one at a time. What type of sample is this?

a. Snowball b. Random c. Stratified random d. Systematic ANS: C Stratified random sampling is used when the researcher knows some of the variables in the population that are critical to achieving represent ativeness. Variables comm only used for stratification are age, gender, ethnicity, socioeconomic status, diagnosis, ge ographical region, type of institution, type of care, care provider, and site of care. The dog has no agenda, and the balls are mixed. The dog choose s 10 balls from each stratum. The sample is stratified random.

DIF: Cognitive Level: Application REF: MCS: 359

5. Good morning. You have been selected randomly by our marketing department because of your recent purchase of McCarthys Natural Yogurt, several organic raw vegetables, and two types of tofu. As a woman with interest in safe and healthy products, we are asking you t o participate in a brief telephone survey. The discerning student will detect an error in the above statement. What kind of a sampling is this?

a. Random sampling b. Convenience sampling c. Purposive sampling d. Systematic sampling ANS: C Marketing research now use s product profiling to identify what consumers buy which products. A sam ple based on profiling is a purposive sample : people are contacted because they possess a certain pattern of purchasing. This is also referred to as judgmental or selective sampling. If a sam ple is purposive, it is not random, convenience, or systematic.

DIF: Cognitive Level: Application REF: MCS: 362

6. A graduate student has a close friend who is recovering fr om colon cancer and has a permanent colostom y.

For her masters thesis, the student decides t o conduct qualitative rese arch on adjustment to living with a permanent colost omy after colon cancer resection. She asks her friend if she has any ide a of how t o recruit participant s for the research. Her friend tells her about a colon cancer support group to which she belongs and volunteers to bring a printout of the research studys purpose and general de scription to the next support group meeting. If the researcher acquires all of her participant s in this way, what is the method of sam pling used?

a. Snowball sampling b. Cluster sampling c. Purposive sampling d. Simple random sampling ANS: A Network sampling, sometimes referred to as snowballing, holds promise for locating sample s difficult or impossible to obt ain in other ways or who had not been previously identifie d for study. Network sampling takes advantage of social networks and the fact that friends tend t o have characteristics in comm on. When the researcher has found a few subject s with the necessary criteria, he or she asks their assistance in getting in touch with other s with similar characteristics. The first few subjects are often obt ained through a convenience sampling method, and the sample size is expanded using network sam pling. In cluster sam pling, the researcher develops a sampling frame that includes a list of all the states, cities, institutions, or organizations with which elements of the identified population would be linked. States, cities, institutions, or organizations are selected randomly as unit s from which to obtain elements for the sample . In purposive sampling, sometimes referred to as purposeful, judgment al, or selective sam pling, the rese archer consciously selects certain participants, elements, events, or incidents toinclude in the study.

DIF: Cognitive Level: Application REF: MCS: 366

7. A researcher has already written a study proposal and performed a power analysis, which indicates that the sample size will have to be at least 36 if a type II error is to be avoided. The

researcher then decides to set the level of significance at p <.01 rather than p <.05 but want s to maint ain power at 0.8. What will the researcher have to do in order to maintain sufficient power?

a. Increase the effect size. b. Set beta at 0.60. c. Use a different statistical test. d. Increase the sample size.

ANS: D You determine the sam ple size needed to obt ain sufficient power by performing a power analysis. Power analysis includes the standar d power (usually 80%), level of significance (usually set at 0.05 in nur sing studie s), effect size, and sample size. In order to demonstrate st atistical significance at a more stringent level (a decreased alpha), the sample size must be increased. The effect size is determined by the magnitude of effect that the intervention produces and, consequently, cannot be adjusted.

DIF: Cognitive Level: Application REF: MCS: 367

8. A researcher studying depression in relation to five predictor variable s decides to include five more variables in the study because the literature reveals that they may also be involve d in depression.

Consequently, the researcher will do which of the following?

a. Use a larger sample size. b. Set beta at a lower level. c. Perform additional reliability and validity tests. d. Change the design of the research from correlational to descriptive.

ANS: A As the number of variable s under study grows, the needed sample size increases. Adding variable s such as age, gender, ethnicity, and education to the analysis plan can increase the sample size by a factor of 5 to 10 if the selected variables are uncorrelated with the dependent variable. Setting beta lower, performing additional reliability and validity tests, and changing the

design from correlational to de scriptive will not solve the problem of the altered power of the study, due to addition of five variables. Only increasing the sample size will be a practical solution.

DIF: Cognitive Level: Application REF: MCS: 370

9. How does effect size relate to instrument sensitivity? a. If an instrument is sensitive, it will have a large effect size. b. If an instrument is not very sensitive, it will take a large effect size for the instrument to detect a difference.

c. As an instrument is better calibr ated and become s more sensitive, it increase s effect size.

d. If an instrument is extremely sensitive, it will detect a difference even when none exist s; because of this effect sizes must be large.

ANS: B Well-develope d instruments measure phenomena with precision. The more sensitive the measurement methods used in a study, the better they will detect even a sm all effect size. A sensitive instrument does not produce an effectit measures it. Effect size is not altered by calibration of instruments; again, sensitivity does not increase effect size. A le gitimate instrument detects a difference when one exist s, and only when one exists.

DIF: Cognitive Level: Analysis REF: MCS: 370

10. A teacher is supposed t o be randomly assigning her student s to experimental and control groups, for participation in a learning project mandated by the school district. She has a master list of the alphabetized students, num bered 1 through 30. Which of the following is the m ost logical way to randomly assign the students to groups?

a. Put numbers 1 to 30 in a hat, draw them out one by one, and put them int o alternating groups.

b. Place the first 15 subjects in one group and the last 15 in the other group. c. Ignore numbers and let the students choose their groups.

d. Put numbers 1 to 30 in a hat, dr aw one, placing it in the experimental group. Then find a student with similar gender, attributes, and abilities, and put that one int o the control group.

Then go back to the hat for the next experimental subject.

ANS: A Random assignment is similar t o random selection in that elements are selected at random fr om the sampling frame. To achieve simple random sam pling, element s are selected at random from the sam pling frame. This goal can be accom plishe d in a variety of ways, limited only by the imagination of the researcher. If the sampling frame is sm all, the re searcher can write name s on slips of paper, place the name s in a container, mix well, and then draw out one at a time until the de sired sample size has been reached. Another technique is t o assign a number to each name in the sampling fr ame. The traditional hat draw is a random method for selection and for assigning. Placing the student s into gr oups by the alphabet is arbitrary, not random. Allowing students to choose their groups turns the study into a quasi -experimental one . Randomly dr awing only the experimental subjects one by one and then finding one s with similar attributes to go into the control group is a kind of matching, not random assignment.

DIF: Cognitive Level: Application REF: MCS: 356

11. Which of the following types of sampling is least common in qualitative research? a. Convenience b. Purposive c. Snowball d. Random ANS: D Nonrandom sampling prevails in qualitative rese arch. Of the five methods in the text, purposive sampling, network sampling, and theoretical sampling are m ore commonly applied in qualitative studies than in quantitative studies. Convenience and quota sampling may also be used, but they are less common.

DIF: Cognitive Level: Application REF: MCS: 362

12. A pollster wants t o obtain a large sam ple of voters with the least amount of trouble . Each subject is asked to complete a pencil-paper questionnaire containing seven multiple -choice que stions. Each person completing the survey receives a $1-off coupon for a population coffee chain. The pollster decides to stand outside twenty different supermarket s for four hours e ach and ask patrons to participate in the research.

Which method of sampling is this?

a. Network or snowball sampling b. Purposive sampling c. Convenience sampling d. Cluster sampling ANS: C Convenience sampling involves the nonrandom selection of subjects who meet criteria and are available and willing to be in the study, or basically subjects who are in the right place at the right time. Thus, this is the easiest, m ost economic method to obt ain a large sam ple. In purposive sampling, sometimes referred to as purposeful, judgmental, or selective sampling, the researcher consciously selects certain participant s, elements, events, or incidents to include in the study. In purposive sam pling, qualit ative researchers select information-rich cases, or those cases that can teach them a great deal about the central focus or purpose of the study. This is almost exclusively a qualitative sampling strategy. Network or snowball sam pling takes advantage of social networks to recruit subjects and is almost exclusively a qualit ative sampling strategy.

Cluster sampling is a type of random sampling.

DIF: Cognitive Level: Application REF: MCS: 358

13. A researcher contact s se ven large hospitals and m ake s arrangements to recruit 55 patients fr om each of their emergency rooms. If this is cluster sampling, how were the seven large hospitals chosen?

a. By size b. By random selection c. By availability d. By researcher familiarity

ANS: B In cluster sampling, a sam pling frame is developed that includes a list of all the states, cities, institutions, or organizations with which elements of the identified population would be linked. States, cities, institutions, or organizations are selected randomly as units from which to obt ain elements for the sample. In some case s, random selection continues through several stages and is then referred to as multistage cluster sampling.

DIF: Cognitive Level: Application REF: MCS: 361

14. To be considered eligible for the study, subjects had to be older than 21 year s of age, hold a valid state drivers license, and be able to fire a shotgun. This is an example of which of the following?

a. Inclusion plan b. Population element c. Sampling criteria d. Representativeness ANS: C Sampling criteria, also referred to as eligibility criteria or inclusion criteria, include a list of characteristics essential for membership or eligibility in the t arget population. The criteria are developed fr om the research problem, the purpose, a review of literature, the conceptual and operational definitions of the study variable s, and the design. The sampling criteria determine the target population, and the sample is selected from the accessible population within the target population DIF: Cognitive Level: Application REF: MCS: 363

15. Five hundred persons were chosen to participate, 270 women and 230 men, representative of the population of Portland, Oregon, treated for conge stive heart failure at one of its four m ain hospitals. Patients were selected using a t able of random number s, fr om a master list of all patients who had been treated for CHF in the previous three months. This is an example of what type of sampling strategy?

a. Simple random sampling b. Convenience sampling c. Purposive sampling d. Stratified random sampling ANS: D Stratified random sam pling is used when the researcher knows some of the variable s in the population that are critical to achieving representativene ss. Variables commonly used for stratification are age, gender, ethnicity, socioeconomic status, diagnosis, geogr aphical region, type of institution, type of care, care provider, and site of care. The variable or variable s chosen for stratification need to be correlated with the dependent variables being examined in the study. Subjects within each stratum are expected to be more alike (homogeneous) in relation to the study variables than they are to be like subjects in other strata or the total sample. In stratified random sam pling, the subjects are randomly selected on the basis of their classification into the selected strata.

DIF: Cognitive Level: Application REF: MCS: 359

16. A research study examine d the partying styles of student s in fraternities, in sororities, living in dorms, and living in private residences. Ten student s from each group were included in the research. This is an example of which type of sampling strategy?

a. Quota sampling b. Cluster sampling c. Purposive sampling d. Stratified random sampling ANS: A Quota sampling uses a convenience sampling technique with an added feature, a strategy to e nsure the inclusion of subject types or strata in a population that are likely to be underrepresented in the convenience sample , such as women, minority groups, the elderly, the poor, the rich, and the undereducated. This method may also be used to mimic the known

characteristics of the target population or to ensure adequate numbers of subjects in each stratum for the planne d statistical analyses. The technique is similar to that used in stratified random sam pling but the initial sample is not random.

DIF: Cognitive Level: Application REF: MCS: 364

17. A sam ple is chosen for a study on average height s and weights of adult male s in a m ajor city. The researcher use s a convenience sampling method, enacting this by going door -to-door in a neighborhood in St. Paul, Minne sot a. Unbeknownst to the rese archer, this neighborhood is very rich in persons of Norwegian descent, who coincide ntally are the t allest Caucasians on the planet. The sampling error that occur s is a result of which of the following?

a. Random variance b. Refusal rate c. Systematic bias d. Type II error ANS: C Systematic variation, or systematic bias, is a consequence of selecting subjects whose measurement value s are different, or vary, in some specific way from the population. Because the subjects have something in comm on, their values tend to be similar to those of others in the sample but different in some way from those of the population as a whole . These value s do not vary randomly around the population mean. Most of the variation from the mean is in the same direction; it is systematic. All the value s in the sample may tend to be higher or lower than the populations me an. Random variation is the expected difference in values that occur s when one examines different subject s from the same sam ple. If the mean is used to describe the sample , the values of individuals in that sample will not all be exactly the same as the sample mean.

Individual subjects value s vary fr om the value of the sam ple mean. The difference is random because the value of each subject is likely to vary in a different direction.

DIF: Cognitive Level: Application REF: MCS: 354

18. Which of the following is the nonprobability sampling method?

a. Cluster b. Quota c. Stratified random d. Systematic ANS: B Four sampling de signs have been develope d to achieve probability sampling: sim ple random sam pling, stratified random sampling, cluster sampling, and systematic sampling.

DIF: Cognitive Level: Comprehension REF: MCS: 358

19. Convenience sampling + stratification = what? a. Stratified random sampling b. Quota sampling c. Purposive sampling d. Cluster sampling ANS: B Quota sampling uses a convenience sam pling technique with an added feature, a strategy to ensure the inclusion of subject type s or strata in a population that are likely t o be underrepresented in the convenience sample, such as women, minority groups, the elderly, the poor, the rich, and the undereducated. This method may also be used t o mimic the known characteristics of the target population or to ensure adequate numbers of subjects in each stratum for the planned statistical analyses.

DIF: Cognitive Level: Synthesis REF: MCS: 364

20. A researcher consented 75 subjects, but 15 dropped out of the study while it was still in pr ogress.

What was the sample attrition rate?

a. 15

b. 15% c. 20% d. 75% ANS: C Sample attrition rate formula = number subjects withdrawing sample size 100%.

For example, if a study had a sample size of 160 and 40 pe ople withdrew from the study, the attrition rate would be 25%.

DIF: Cognitive Level: Application REF: MCS: 356

21. A researcher consented 400 subjects, but 12 dr oppe d out of the study before it was completed. The rest finished the study. What was the sample retention rate? a. 388 b. 38.8% c. 3% d. 97% ANS: D Sample retention rate formula = number subjects completing study sample size 100%. DIF: Cognitive Level: Application REF: MCS: 356

22. A researcher attempted t o recruit all 150 of the patients seen in the emergency de partment in a threemonth period for diverticulitis, but only 120 consented to participate. What is the sample size? a. 150 b. 120

c. 30 d. 80%

ANS: B A refusal rate is the number and percentage of subjects who declined to participate in the study. Patients who refuse to participate are not part of the sample, since they were only potent ial subjects, not actually included in the sample. The refusal r ate is calculated by dividing the number of potential subjects refusing t o participate by the number of potential subjects meeting sampling criteria and multiplying the results by 100%.

DIF: Cognitive Level: Application REF: MCS: 355

23. A researcher attempted t o recruit all 150 of the patients seen in the emergency department in a threemonth period for diverticulitis, but only 120 consented to participate. What is the refusal rate? a. 100% b. 80% c. 20%

d. 0% ANS: C A refusal rate is the number and percentage of subjects who declined to participate in the study. High refusal rates to participate in a study have been linked to individuals with serious physical and em otional illnesses, low socioeconomic status, and weak social networks. The higher the refusal rate, the le ss the sample is representative of the target population. The refusal rate is calculated by dividing the number of potential subjects refusing t o participate by the num ber of potential subjects meeting sampling criteria and multiplying the results by 100%.

DIF: Cognitive Level: Application REF: MCS: 355

24. Using a table of random numbers, the sample of 400 subjects was selected fr om the list of the license numbers of all registered nurses in the state of Michigan. Each nurse was se nt a letter requesting completion of an online survey on workplace bullying. This is an example of what type of sampling method?

a. Simple random sampling b. Quota sampling c. Convenience sampling d. Purposive sampling ANS: A To achieve simple random sam pling, elements are selected at random from the sampling fr ame. This goal can be accom plishe d in a variety of ways, limited only by t he imagination of the rese archer. A random number table is e ffective in selecting numbered elements from a master list. Simple random sam pling ensures that each element of the population has an equal and independent chance of being chosen.

DIF: Cognitive Level: Application REF: MCS: 358

25. When grounded theory researchers recruit subjects who can provide relevant information to explain a cluster of interlocking ideas that is unclear to the researchers, what kind of sampling isused?

a. Theoretical sampling b. Convenience sampling c. Quota sampling d. Network ANS: A Theoretical sampling is usually applied in grounded theory rese arch to advance the de velopment of a selected theory throughout the research process. The researcher gathers data from any individual or group that can provide relevant data for theory generation. The data are considered relevant if they include information that generates, delimits, and saturates the theoretical codes inthe study needed for theory generation.

DIF: Cognitive Level: Synthesis REF: MCS: 366

26. Which is the sampling design that is an example of a probability sampling method? a. Purposive b. Snowball c. Stratified random d. Quota ANS: D There are several types of nonprobability (nonrandom) sampling designs. Each addresse s a different research need. The five nonprobability sampling designs described in this textbook are (1) convenience sampling, (2) quot a sampling, ( 3) purposive or purpose ful sam pling, (4) network or snowball sampling, and (5) theoretical sampling. These sam pling methods are applied in both quantit ative and qualitative research. However, convenience sampling and quota sampling are applied more often in quantitative, outcomes, and intervention research than in qualitative studies and are discussed in this section.

DIF: Cognitive Level: Comprehension REF: MCS: 362 MULTIPLE RESPONSE

1. If the population is E, and assuming the researcher selects part of the population as a sample, what could be the sample? (Select all that apply.)

a. A b. B c. C d. D e. E ANS: A, B, C, D Sampling involves selecting a group of people , event s, behaviors, or other elements with which t o conduct a study. A sample denotes the selected group of people or elements included in a

study sam ple; it is a subset of the population. Every element of the sample is located within the population. In the diagram, A, B, C, and D are totally cont ained within E. T he sampling criteria determine the target population, and the sample is selected from the accessible population withinthe target population.

DIF: Cognitive Level: Application REF: MCS: 351

2. A researcher e-mails an online survey about multi-t asking and overcommitedness both on and off the job, as they relate to quality of life, to a random selection of 20,000 RNs in all 50 states; this represents about 1% of the population of RNs. The return rate on the tool is 5% . The goal of this sam pling method is to obtain a representative sample. Which of the following are correct statements relative to the sam ples representativeness? (Select all that apply.)

a. Since the topic has to do with having too many things going at once, it is likely that the results will be skewed, since RNs who are vastly overcommitted will not complete the survey.

b. The sample is autom atically represe ntative if randomly selected name s were used for the survey e-mailing.

c. If the e-mailed subset of the population was randomly selected and the return meets the number required by power analysis, the return is representative.

d. Subjects whose perceived quality of life is either very high or very low may be more inclined to participate, since they have an interest in finding more out about this relationship.

e. If the 1,000 subjects who return the survey constitute an insufficient number to demonstrate statistical significance, this means that the sam ple was not truly representative.

f. The sample is so huge, it would certainly be representative of the entire population.

ANS: A, D For a sample to be representative, it must be like the target population in as m any ways as possible. It is especially im portant that the sam ple be representative in relation to the variables being studied and to other factor s that m ay influence the study variable s. Random sampling increase s the extent to which the sample is representative of the target population. Even if the

original sam ple is random, persons who volunteer or consent to participate in a study m ay differ in import ant ways from those who are not willing to participate.

DIF: Cognitive Level: Synthesis REF: MCS: 353

3. What would represent a hypothetical population? (Select all that apply.) a. The average population of New Jersey b. Babies born in taxicabs in New York City in the coming year c. The forty-five subjects whose performance supported the study hypothesis d. The percentage of the subjects who score higher than 81 on the Test of Motor Capability e. All of the high school students at Bountiful High School who will earn their Eagle Scout rank in the academic year 20182019 ANS: B, E A hypothetical population assumes the presence of a population that cannot be defined according to sampling theory rules, which require a list of all members of the population. For example, individuals who succe ssfully lose weight would be a hypothetical population. The num ber of individuals in the population, who they are, how much weight they have lost, how long they have kept it off, or how they achieved the weight loss is unknown. S ome populations are elusive and constantly changing. For example , listing all women in active labor in the United State s, all people grieving the loss of a loved one, or all people coming into an emergency department would be impossible to identify.

DIF: Cognitive Level: Application REF: MCS: 352

4. If all of the tickets purchased in this weeks state lottery is considered the population, the five winning tickets drawn on Saturday constitute the sample. If the lottery is not fixed, why is this a probability sample?

(Select all that apply.)

a. Because accor ding to the laws of probability, the group of five people who won is exactly representative of all of the persons who purchased tickets

b. Because each ticket purchased has a chance of being included in the sample

c. Because the tickets drawn have a high pr obability of being representative of all tickets purchased

d. Because use of random sampling increases the probability that those persons whose tickets win will play the lottery again

e. Because each ticket probably has an equal chance of being included in the winning group, whether or not random sampling is used ANS: B, C Probability sampling methods have been develope d to ensure some degree of precision in estimations of the population parameters. Thus, probability sam ples reduce sampling error. T he term probability sample refers to the fact that every member (element) of the population has a probability higher than zero of being selected for the sample. Since all ticket s have a greater than zero chance of winning, and since the tickets drawn have a very good probability of being representative of all tickets purchased, this is a probability sample.

DIF: Cognitive Level: Synthesis REF: MCS: 357

5. Why are broad sampling criteria preferable for descriptive nursing studies? (Select all thatapply.) a. The accessible population is often limited in size. b. They include the sample that is the most representative of the population at thatsite. c. Broad sampling criteria are preferable for studies conducted in natural settings. d. Broad sampling criteria eliminate more extraneous variables than do narrow sampling criteria.

e. Generalization is improved with broad sampling criteria.

ANS: A, B, C, E Broad sam pling criteria ensure a large t arget population of heterogeneous or diverse potential subjects. A heterogeneous sample increases one s ability to generalize the findings to a larger target population. In descriptive or correlational studies, the sampling criteria may be de fined to ensure a heterogeneous population with a broad range of values for the variables being studied.

Descriptive studie s are usually conducted with minimal control of the study design, because subjects are examined as they exist in their natural setting, such as home, work, or school.

DIF: Cognitive Level: Synthesis REF: MCS: 352

6. The population parameter for firefighters on Long Island is 79% male. The sample statistic for three fire stations is 73% male. Why wasnt the sample statistic the same as the population parameter?

a. Sampling error was present. b. Random variation might have occurred. c. Systematic variation might have occurred. d. The sample was fairly small. e. The sample was not perfectly representative. f. The population parameter is inaccurate.

ANS: A, B, C, D, E The difference between a sam ple statistic and a population parameter is called the sampling error. A large sampling error means that the sample is not providing a precise picture of the population; it is not representative. Sam pling error is usually larger with sm all sample s and decrease s as the sample size increases. Sampling error reduces the power of a study, or the ability of the statistical analyse s conducted to detect differences between gr oups or to de scribe the relationships among variables. Sampling error occurs as a result of random variation and systematic variation.

DIF: Cognitive Level: Application REF: MCS: 354

7. What are the true statements about inclusion and exclusion criteria? (Select all that apply.) a. Inclusion and exclusion criteria determine the demographics of the sample. b. Inclusion and exclusion criteria are the opposites of one another. c. Inclusion and exclusion criteria must be mutually exhaustive. d. Inclusion and exclusion criteria must be mutually exclusive.

e. Inclusion and exclusion criteria must address the study purpose.

ANS: A, E A study might have inclusion or exclusion sampling criteria (or both). Inclusion sampling criteria are those characteristics that a subject or element must possess to be part of the target population. Exclusion sam pling criteria are those characteristics that can cause a per son or element to be excluded from the target population.

For age, for instance, excluded if under the age of 18 and included if over the age of 18 are not acceptable exclusion/inclusion criteria because they are not mutually exhaustive: what should the researcher do with someone 18include, or exclude?

Similarly, excluded if 65 or younger and included if 65 or older are not mutually exclusiveagain, what does the researcher do with the 65-year-old?

DIF: Cognitive Level: Analysis REF: MCS: 353

8. Large sample sizes are desirable in which types of research? (Select all that apply.) a. Correlational, using an existent database b. Grounded theory c. Phenomenology d. Pilot interventional research e. Multisite randomized clinical trials f. Survey research g. Model testing h. Case study research ANS: A, E, F, G Descriptive case studies tend to use sm all sample s. Gr oups are not compared, and problems related to sampling error and generalization have little relevance for such studies. A small sam ple size may better serve the researcher who is interested in examining a situation in de pth fr om various perspectives. Other descriptive studies, particularly those using survey que stionnaires, and correlational studies often require large sam ples. In the past, quasi- experimental and experimental studies often used smaller sample s than descriptive and

correlational studies. The sam ple size increases in proportion to the number of variables included in data analysis. In quantitative rese arch, the sample size must be large enough to identify relationships am ong variables or to determine differences between groups. However, in qualit ative rese arch, the focus is on the quality of information obtained from the per son, situation, or event sam pled versus the size of the sample.

The intent is an in-depth understanding of a purposefully selected sample and not the generalization of the findings fr om a randomly selected sample to a target population, as in quantitative rese arch. The num ber of participants in a qualitative study is adequate when saturation of information is achieved in the study area.

Grounded theory and phenomenology are types of qualitative research. A pilot study is a smaller version of a proposed study conducted to develop and refine the methodology or intervention hence it uses a smaller sample size.

DIF: Cognitive Level: Synthesis REF: MCS: 369

9. A hospital-based nurse researcher at Hospital A conduct s experimental research on a rotating bed and its effect on prevention of pressure ulcers in hip fracture patient s over 80 year s of age with cognitive functional impairment. Because there are so few patients over 80 with fractured hips and cognitive functional impairment, and because the researcher anticipates problem s with obtaining consent, a convenience sample is utilized and e very patient who meets the criteria and consent s is used in the study. The bed, although expensive, is found to be much more effective in preventing pressure ulcers in this population than is turning alone. The study is published. What are the implications of applying these findings, considering the researchers use of a convenience sample? (Select all that apply.)

a. The findings can be applied to similar patients who come to Hospit al A, with the understanding that data collection will continue and represent a second stud y, since the research is unreplicated.

b. The findings may be applicable to similar patients who come to Hospital B, but without replication, this use cannot be mandated in the research report.

c. The rotating bed should not be used outside of Hospit al A at all until a replication study is conducted.

d. The study findings probably represent a type I error. It is doubtful that use of a rotating bed could produce significant findings with a convenience sample.

e. The widespread use of the rotating bed has not been supported.

f. Generalization is appropriate only extremely cautiously and in the same site in which the study was conducted, with tracking of subsequent data.

ANS: A, B, E, F In convenience sam pling, any patients who meet the inclusion criteria are recruited for the study. Convenience sampling is considered a weak approach to sampling because it provides little opportunity to control for biase s. Multiple biases may exist in convenience sampling; the se biase s range from minimal to serious.

Additional studies with large convenience sample s that have similar results would indicate the effectiveness of this intervention for practice. Studies with small convenience samples should be replicated to determine the accuracy of the findings and to increase the representation of the population studie d. If findings are consistent over replications, then generalization to a larger group is possible.

DIF: Cognitive Level: Analysis REF: MCS: 363

10. Why are convenience samples used so frequently in nursing research? (Select all that apply.) a. More subjects consent if they can understand the sampling method. b. Obtaining a true random sample may be impossible. c. There is low risk of sampling bias. d. There are limited subjects available. e. Nonrandom sampling affects only generalizability, not study integrity.

ANS: A, D, E The majority of nursing studie s use nonprobability sampling, especially convenience sampling, to select study samples. In conducting studies in nursing and other health disciplines, there are limited subjects available and often a random sample is not possible to obt ain. Rese archers often include any subjects willing to participate who meet the eligibility criteria. Nonrandom sampling affects only generalizability, not any other type of validity.

DIF: Cognitive Level: Analysis REF: MCS: 362

11. If researchers are attempting to recruit subjects who are members of a group is not mainstream and may be disdained, why is snowball sampling often used?

a. It is less time-consuming than other methods, for hard-to-access populations. b. It produces a sample that is more representative. c. It increases recruitment success. d. It produces a more diverse sample. e. It increases generalizability.

ANS: A, C Network sam pling, which also is referred to as snowball or chain sam pling, holds promise for locating samples difficult or impossible to obtain in other ways or who had not been previously identified for study.

Network sam pling take s advant age of social networ ks and the fact that friends tend to have char acteristics in common.

DIF: Cognitive Level: Evaluation REF: MCS: 353

12. Why would a researcher use an elimination criterion like Must not have baseline liver function tests that are outside the normal range? (Select all that apply.)

a. Impaired liver function m ay have been identified by the rese archer as an extraneous variable.

b. The intervention planned by the rese archer could have an adverse e ffect on individuals with impaired liver function.

c. Liver function test s are possibly being measured in order to detect the independent variables effect on the dependent variable.

d. The researcher is attempting to eliminate persons with all lab test s that are out side normal range.

e. The dependent variable may be abnormally elevated in persons who do not have normal liver function.

ANS: A, B, C, E

Exclusion sampling criteria are those characteristics that can cause a person or element to be excluded from the target population. The usual reasons for exclusion criteria are that they are extraneous variable s and, if present, they could affect the value of the de pendent variable. Other reasons might include increased risk for some groups.

DIF: Cognitive Level: Synthesis REF: MCS: 353

13. Performing a power analysis allows the researcher to calculate adequate sample size. Why is this preferable to accomplish in the design phase of a quantitative study? (Select all that apply.)

a. A sam ple of sufficient size m aximizes the chance of detecting statistical significance.

b. Performing a power analysis increases the researchs potential for publication. c. Conducting a power analysis decreases the chance of a type I error. d. Conducting a power analysis increases effect size. e. The institutional review paperwork must include a maximum sample size.

ANS: A, E The deciding factor in determining an adequate sample size for correlational, quasi -experimental, and experimental studies is power. Power is the capacity of the study to detect difference s or relationships that actually exist in the population. Expressed another way, power is the capacity to correctly reject a null hypothe sis. Often the minimum accept able power for a study is 0.80. If a rese archer does not have sufficient power to detect differences or relationships that exist in the population, one might question the advisability of conducting the study. Therefore, it is advisable to conduct the power analysis in the de sign phase so as to ensure an adequate sam ple size is obt ained. One of the items required by the Institutional Re view Board is a description of the subjects the researcher plans to use in the study. This includes the maximum number of subjects anticipated.

DIF: Cognitive Level: Evaluation REF: MCS: 367

14. The researcher conducts a qualitative study that explore s the feelings of nurse s who care for victims of intentional burning. What sampling methods are most appropriate for this study? (Select all that apply.)

a. Quota sampling b. Purposive sampling c. Cluster sampling d. Stratified random sampling e. Systematic sampling f. Snowball sampling g. Theoretical sampling ANS: B, F, G Purposive sampling, networ k sampling, and theoretical sampling are used more frequently in qualitative studies than in quantitative studie s. In purposive sampling, sometimes referred to as purposeful, judgmental, or selective sampling, the rese archer consciously selects certain participants, element s, event s, or incidents t o include in the study. In pur posive sampling, qualitative researcher s select information-rich case s, or those case s that can teach them a great deal about the central focus or purpose of the study. Network sampling, sometimes referred to as snowball or chain sampling, holds promise for locating samples who are difficult or impossible to obt ain in other ways or who had not been previously identified for study. Network sampling takes advantage of social networks and the fact that friends tend to have characteristic s in common.

Theoretical sam pling is usually applied in grounded theory rese arch to advance the development of a selected theory throughout the research process (Munhall, 2012). The rese archer gathers dat a fr om any individual or group that can provide relevant data for theory generation.

DIF: Cognitive Level: Application REF: MCS: 362

15. Why are convenience samples used so frequently in nursing rese arch, whe n a r andom sample would allow for greater generalizability? (Select all that apply.)

a. Convenience sampling allows re searchers to select not only subsets but qualities associated with them.

b. Key informants are desired. c. Random sampling is really not an issue, since little nursing research is replicated.

d. Subjects are difficult to recruit when they are ill. e. Nurses are limited to the populations they serve; m any populations are small and difficult t o access.

ANS: D, E Thus, nonprobability sampling methods increase the likelihood of obt aining samples that are not representative of their target populations. However, the majority of nursing studies use nonprobability sampling, especially convenience sam pling, to select study samples. In conducting studie s in nursing and other health disciplines, there are limited subjects available and often a random sample is not possible to obtain. Researchers often include any subjects willing to participate who meet the eligibility criteria.

DIF: Cognitive Level: Synthesis REF: MCS: 362

16. A study has a power level of .75. What does that mean? (Select all that apply.) a. Study interventions will be statistically significant 75% of the time. b. The study has a 75% chance of detecting differences if they exist. c. The studys sample has a 25% attrition rate, at worst. d. There is a 25% chance of detecting a type I error. e. There is a 25% chance that the study will fail to reveal differences that actually exist.

ANS: B, E Power is the capacity of the study to detect differences or relationships that actually exist in the population.

Expressed another way, power is the capacity to correctly reje ct a null hypothesis. The minimum accept able power for a study is commonly recommended to be 0.80 (80%).

Howe ver, the researcher can set this lower, if the researcher is willing to risk a larger likelihood of a type II error.

DIF: Cognitive Level: Application REF: MCS: 367

17. Which of the following are true statements related to determination of minimum sam ple size? (Select all that apply.)

a. In inferential quantitative research, power analysis drives sample size. b. In pilot research, ability to address the purpose for the pilot drives sample size. c. In descriptive research, availability of subjects drives sample size. d. In both quantitative and qualitative research, available funding drives sample size. e. In qualitative research, theoretical saturation drives sample size.

ANS: A, B, C, E Currently, the deciding fact or in determining an adequate sample size for correlational, quasi- experimental, and experimental studies is power. Power is the capacity of the study to detect differences or relationships that actually exist in the population. Determining the sam ple size nee ded to obtain sufficient power is made by performing a power analysis. In descriptive or de scriptive correlational research conducted in a natural setting, it is usual t o include all available subjects.Sample size in both quantitative and qualitative rese arch should be determined by the researchers available funding. The number of participants in a qualit ative study is ade quate when satur ation of inform ation is achie ved in the study area, which occurs when additional sampling provides no new information, only redundancy of previously collected data. A pilot studys sample size is very smalljust enough to address the reason the pilot was conducted. For instance , a small pilot study can be per formed to measure the effect size, so that the researchers can perform an informed power analysis for the subsequent quantitative study, estimating its requiredsample size appropriately.

DIF: Cognitive Level: Synthesis REF: MCS: 367

18. Why is a large refusal rate a barrier to widespread generalization? (Select all that apply.) a. If a study has a refusal rate higher than thirty percent, it is no longer considered research. b. If researchers cannot recruit subjects into their research studie s, their credibility and ethics are under serious scrutiny.

c. The actual sample is not representative of the population. It is representative only of the elements of the population that chose to participate.

d. If many persons refuse to participate, they might refuse to participate in interventions that the study recommends.

ANS: A, B, C Sampling theory was develope d to determine mathematically the most effective way to acquire a sample that would accurately reflect the population under study. For a sample to be representative, it must be like the target population in as m any ways as possible. It is e specially important that the sample be represent ative in relation to the variables being studied and to other factors that may influence the study variables. A sam ple must be representative of the demographic characteristics, such as age , gender, ethnicity, income, and education, which often influence study variable s. The accessible population must be representative of the target population. If the acce ssible population is limited to a particular setting or type of setting, the individuals seeking care at that setting may be different from those who would see k care for the same problem in other settings or from those who choose to use self-care to manage their problems. Representativeness is usually evaluated through com parison of the numerical values of the sam ple (a statistic such as the mean) with the same values from the target population.

DIF: Cognitive Level: Synthesis REF: MCS: 353

19. Why is survey research subject selection considered nonrandom? (Select all that apply.) a. If monetary reward is offered as an inducement, subjects may participate only to get the reward. The sample may include fewer people who are well off financially.

b. There is no direct contact with the subjects. c. Follow-up reminders make recruitment long and drawn-out. d. Inducements are essentially manipulative; potential subjects who resent manipulation refuse to return surveys.

e. Refusal rates average 50% or more, and this makes the sample nonrepresentative.

ANS: A, D, E

In conducting a surve y study, the researcher may never have personal contact with the subjects. To recruit such subjects, one must rely on the use of attention -getting technique s, per suasively written material, and strategies for following up on individuals who do not respond t o the initial written or e-m ail communication.

Because of the serious problems of low re sponse r ates in survey studie s, using strategies t o raise the response rate is critical. In some case s, sm all amounts of money ($1 to $5 dollar s) are enclosed with the letter. This may produce a feeling of obligation on the part of the potential participant. Survey research return rate varie s fr om 5% through about 50% for most studie s. Interestingly, the accuracy of re sponse s in survey rese arch is slightly better with a lower return!

DIF: Cognitive Level: Comprehension REF: MCS: 376

20. Inclusion criteria differ from sam ple characteristics. Which of the following are sample characteristics from a study conducted in a neurosurgical critical care unit of a major hospital? (Select all that apply.)

a. Mean age 62, with range from 37 through 87 b. Diagnosed with neurologic impairment due to trauma or disease c. Glasgow Coma Scale range 4 to 15 d. Twenty-one male, nineteen female e. Able to speak English or Spanish ANS: A, C, D Inclusion criteria are those characteristics that a subject or element must posse ss to be part of the target population. Sam ple characteristics are a de scription of the subjects who participated in the study; in a nursing study, these often contain information about age, gender, diagnosis, and medical condition.

DIF: Cognitive Level: Synthesis REF: MCS: 351

21. Inclusion criteria differ from sample char acteristics. Which of the following are inclusion criteria for a study conducted on an acute care ward of a major hospital? (Select all that apply.)

a. Mean age 62, with range from 37 through 87 b. Twenty-four male, twelve female c. Glasgow Coma Scale of at least 14 d. Twenty-one post hip replacement, fifteen post knee replacement e. Able to read and write English ANS: C, E Inclusion criteria are those characteristics that a subject or element must possess to be part of the target population. They are like a list of what you are fishing for when you go out in a boat.

Sample characteristics are a de scription of the subjects who participated in the study; in a nursing study, these often contain information about age, gender, diagnosis, and medical condition. They are like a list of what fish you caught on the fishing trip.

Chapter 16. Measurement Concepts MULTIPLE CHOICE

1. A shepherd in the wilds of eastern Nevada is counting his sheep at the end of a work day. What is another term for what he is doing?

a. Estimating random error b. Measuring c. Using an interval level of measurement d. Calculating risk ratios ANS: B Measurement is the process of assigning numbers to objects, event s, or situations in accord with some rule.

The numbers assigne d can indicate numerical values or categories for the object s being measured for research or practice.

DIF: Cognitive Level: Application REF: MCS: 382

2. What kind of reliability testing is used extensively in qualitative research? a. Equivalence reliability b. Stability reliability c. External consistency d. Internal consistency ANS: A Equivalence reliability compares two versions of the same paper-and-pencil instrument or two observers measuring the same event. Determining interrater reliability is a concern when studies include observational measurement, which is comm on in qualitative rese arch. Interrater reliability values need to be reported in any study in which observational dat a are collected or judgments are made by two or more data gatherers.

Consequently, it is used in various types of qualitative research in which data or behaviors are coded.

DIF: Cognitive Level: Analysis REF: MCS: 390

3. Why would interrater reliability be measured in a quantitative research project? a. A verbal quantitative questionnaire is filled out. b. Behavior is observed and classified. c. Phenomenology is the research method. d. Distances are measured.

ANS: B Determining interrater reliability is a concern when studies include observational measurement, which is common in qualit ative research. Interrater reliability value s need to be reported in any study in which observational data are collected or judgment s are made by two or more data gatherers. Consequently, it is used in various types of qualitative research in which data or behaviors are coded or classified.

DIF: Cognitive Level: Analysis REF: MCS: 390

4. What is the purpose of determining an instruments internal consistency? a. It establishes face validity. b. It demonstrates that the instrument is measuring exactly what the researcher thinks it is measuring.

c. It decreases measurement error. d. It is a way of establishing test-retest reliability.

ANS: D Tests of instrument internal consi stency or homogeneity, used primarily with paper-and-pencil test s or scales, address the correlation of various items within the instrument. The original approach to determining internal consistency was split-half reliability. This strategy was a way of obt aining test -retest reliability without administering the test twice.

DIF: Cognitive Level: Application REF: MCS: 391

5. A new tool and very short tool is developed. It is to be used instead of a previously validated tool that is very long to administer. What kind of validity concept will be used for testing this new tool?

a. Divergent validity b. Convergent validity c. Discriminant analysis d. Content validity ANS: B In examining the validity of the new instrument, it is import ant to determine how closely the existing instruments measure the same construct as the newly developed instrument (convergent validity). Divergent validity would measure the differences in measurement, between an existing instrument and a newly develope d one. Discriminant analysis measures the difference between two related but not identical concepts. Content validity is the extent to which a measurement represents the concept being measured.

DIF: Cognitive Level: Application REF: MCS: 400

6. Which one of the following instructions to the research subject will provide the highest possible level of measurement?

a. Indicate whether your income is above $20,000 a year or not. b. What was your income last year: $0$20,000; $20,000$60,000; $60,000$100,000; or more than $100,000?

c. What was your total income last year, before taxes? Enter amount: d. Did you earn money last year?

ANS: C An important rule of measurement is that one should use the highest level of me asurement possible. For example, you can collect data on age (measured) in a variety of ways: (1) you can obt ain the actual age of e ach subject (ratio level of measurement); (2) you can ask subjects to indicate their age by selecting from a gr oup of categories, such as 2029, 3039, and so on ( ordinal level of me asurement); or ( 3) you can sort subjects into two categories of under 65 years of age and 65 years of age and older (nominal level of measurement).

DIF: Cognitive Level: Application REF: MCS: 387

7. A band is in on a multi-city t our, and souvenir shirts are ordered from a fact ory. They are shipped without the size labels. The ve ndor must then sort them into size sapparently they are sm all, medium, large, extra-large, and extra-extra-large. What level of measurement is this?

a. Nominal b. Ordinal c. Interval d. Ratio ANS: B Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. Nominal level of measurement is the lowest of the four measurement levels or

categories. It is use d when data can be organized into categories of a de fined property but the categories cannot be or dered. It merely name s. In interval level of measurement, distance s between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of value s. They are almost exclusively manmade scale s, measures, inventorie s, and so forth. Ratio level of measurement is the highe st form of measure and meets all the rules of the lower form s of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 386

8. A secretary in a veterinarians office keeps track of how m any animals come in for care in a weeks time and what types of animals they are: cat , dog, hor se, gerbil, duck, snake, and so forth. What level of measurement is this?

a. Nominal b. Ordinal c. Interval d. Ratio ANS: A Nominal level of me asurement is the lowest of the four measurement levels or categories. It is used when dat a can be organized into categories of a defined property but the categories cannot be ordered. It merely names.

Data that can be measured at the ordinal level can be assigne d to categories of an attribute that can be ranked.

In interval level of me asurement, dist ances between intervals of the scale are numerically equal. Interval scale s are assumed to be a continuum of values. They are alm ost exclusively manm ade scale s, me asure s, inventories, and so forth. Ratio le vel of measurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 386

9. Mark is in third grade and has just learned how to use a ruler to measure. He has become a me asuring fool. He measures everything in the house, writing down all the measurements, and

gaily announcing t o his mom, Hey, Mom . Gue ss what? The salt shaker is four and a quarter inche s tall.

What level of measurement is this?

a. Nominal b. Ordinal c. Interval d. Ratio ANS: D Ratio level of me asurement is the highest form of me asure and meets all the rule s of the lower forms of measures. It uses the real num ber scale , on which zero means none of the variable being me asured. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized int o categories of a define d property but the categories cannot be ordered. It merely names. Dat a that can be measured at the ordinal level can be assigne d to categories of an attribute that can be ranked. In interval level of me asurement, distances between intervals of the scale are numerically equal. Interval scale s are assume d to be a continuum of value s. They are almost exclusively manmade scales, measures, inventories, and so forth.

DIF: Cognitive Level: Application REF: MCS: 387

10. Depression is measured by the Beck Depression Inventory, which adds up scores from 21 items to provide a total value ranging from 0 to 63. What level of measurement is this?

a. Nominal b. Ordinal c. Interval d. Ratio ANS: C In interval level of measurement, dist ances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. They are almost exclusively manmade

scale s, measures, invent ories, and so forth. Nominal le vel of measurement is the lowest of the four measurement levels or categories. It is used when dat a can be organized int o categories of a defined property but the categories cannot be ordered. It merely names. Dat a that can be measured at the ordinal le vel can be assigned to categories of an attribute that can be ranked.

Ratio level of me asurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 387

11. Inclusion criteria and exclusion criteria in sample selection are mutually exclusive and mutually exhaustive. A researcher has a list of all of the studys inclusion and exclusion criteria. These then must be sorted into an inclusion list and an exclusion list. The method of sorting may be considered

a. Nominal b. Categorical c. Interval d. Ratio ANS: A Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a define d pr operty but the categories cannot be ordered. A study might have inclusion or exclusion sampling criteria (or both). Inclusion sam pling criteria are those characteristics that a subject or element must possess to be part of the target population. Exclusion sampling criteria are those characteristics that can cause a person or element to be excluded fr om the target population. For age, for inst ance, excluded if under the age of 18 and include d if over the age of 18 are not acceptable exclusion/inclusion criteria because they are not mutually exhaustive: what should the researcher do with someone 18include, or exclude? Similarly, excluded if 65 or younger and included if 65 or older are not mutually exclusiveagain, what does the researcher do with the 65-year-old?

DIF: Cognitive Level: Evaluation REF: MCS: 386

12. A student finds a t ool that measures adaptability that she wants to use for her masters thesis. It has 25 items, and they are all of the ordinal level, scale d 0 through 5. The level of measurement of the tool is said by its authors, pragmatics all, to be which of the following?

a. Ratio level b. Interval level c. Ordinal level d. Nominal level ANS: D Pragmatists often treat ordinal data from multiple item scales as interval dat a, using statistical methods to analyze them such as the Pearsons Product-Moment Correlation Coe fficient, t-test, and analysis of variance (ANOVA), which are traditionally reserved for interval or ratio level data. Fundamentalists insist that the analysis of or dinal dat a be limited t o st atistical procedure s de signed for ordinal data, such as nonparametric procedures.

DIF: Cognitive Level: Analysis REF: MCS: 388

13. Interval scale s of measurement (IQ tests, anxiety inventories, mental st atus exam s) are product s of mans invention how frequently?

a. Never b. Sometimes c. Frequently d. Always ANS: D In interval level of measurement, distances between intervals of the scale are numerically equal. Such measurements also follow the previously mentione d rules: mutually exclusive categories, exhaustive categories, and rank ordering. Interval scale s are assumed to be a continuum of values. Thus, the researcher can identify the magnitude of the attribute much more precisely.

However, it is not possible to provide the absolute amount of the attribute because of the absence

of a zero point that really means zero on the interval scale. Interval scales are commonly use d for sur veys, scales, and inventories.

DIF: Cognitive Level: Analysis REF: MCS: 387

14. Tests of st ability reliability, such as test-retest, can reveal random measurement error. Why is system atic measurement error not revealed when stability reliability determinations are made?

a. Actually, reliability testing does not reveal the type of error: differences on test - retest can indicate problems with both random and systematic measurement error.

b. Tests of st ability reliability are not powerful enough to pick up systematic measurement error because of its subtlety.

c. If an instrument systematically measures all blood pre ssures 10 points high, it will do so both at baseline and on retesting.

d. The direction of the systematic measurement error is reversed on retesting, so it is not visible in the statistical analysis.

ANS: C Stability reliability is concerned with the consistency of repeated me asures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test -retest reliability. This measure of reliability is generally used with physical measures, technological measures, and paper-and-pencil scales. The technique requires an assum ption t hat the factor to be me asured remains the same at the two testing times and that any change in the value or score is a consequence of random error.

DIF: Cognitive Level: Analysis REF: MCS: 389

15. Specificity of an instrument used for diagnosis refers to what? a. Its ability to detect error b. Its ability to detect the presence of a condition or illness c. Its ability to detect the absence of a condition or illness d. Its true positives minus its false negatives ANS: C

Specificity of a screening or diagnostic test is the proportion of patients without the disease who have a negative test result or true negative. A test with high specificity is very good at identifying the patient without any disease.

DIF: Cognitive Level: Comprehension REF: MCS: 407 MULTIPLE RESPONSE

1. Which of the following must be measured indirectly? (Select all that apply.) a. Number of miles from San Francisco to Disneyland b. Level of consciousness c. Height d. Hope e. Liver function ANS: A, D, E An abstract concept is not measured directly; inste ad, indicator s or attributes of the conce pt are used to represent the abstraction. This is referred to as indirect measurement. In addition, hard - to-access physiologic and behavioral variables and huge quantities may be measured indirectly.

DIF: Cognitive Level: Application REF: MCS: 383

2. Which of the statements is true, relative to error? (Select all that apply.) a. True score plus error score equals observed score. b. Random error of measurement increases the mean. c. The mean of the true measurements is equal to the mean of the observed measurements when there is no systematic error.

d. No measurement of anything is ever correct. e. Measurement error always exists, if a straightforward measurement like counting is made often enough and by enough people.

ANS: A, C, E

Observed score = true score + random error. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained variance around the mean.

Measurement error is the difference between what exists in reality and what is measured by aninstrument.

DIF: Cognitive Level: Analysis REF: MCS: 383

3. Which of the statements is true relative to systematic error? (Select all that apply.) a. If the amount of the systematic error is known, true scores can be retrieved. b. Systematic error may be decreased by proper instrument calibration. c. Systematic error results in values that vary in one direction from the true scores. d. Systematic error results from researcher fatigue or inattention. e. Systematic error changes the mean but not the relative magnitude of the variance.

ANS: A, B, C, E Observed score = true score + systematic error. Measurement error that is not random is referred to as systematic error. For example, a scale that weighed subjects three pounds more than their true weights demonstrate s system atic error. All of the body weights would be higher, and, as a result, the mean would be higher than it should be. Systematic error results in error in one direction. Consequently, the mean is either higher or lower, but the relative magnitude of the variance should remain the same. Systematic error occurs because something else is being measured in addition to the concept.

DIF: Cognitive Level: Analysis REF: MCS: 383

4. What is the true statement, related to stability reliability? (Select all that apply.) a. It is useful for establishing the validity of a physiologic measure. b. It establishes the consistency of repe ated measures of the same attribute with the use of the same scale or instrument over time.

c. It reveals random error but not systematic error. d. It is sometimes referred to as test-retest reliability.

e. It may be difficult to interpret whether a measurement has unacceptable stability reliability or whether maturation has affected subjects responses.

ANS: B, C, D, E Stability reliability is concerned with the consistency of repe ated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test -retest reliability. Because it measures the same variable in the same manner, it reveals only random error, not systematic error. Testretest reliability requires the assum ption that the factor being measured has not changed between the measurement points. Many of the phenomena studied in nur sing, such as hope , coping, pain, and anxiety, do change over short intervals. Thus, it is difficult to determine whether change represents measurement error or valid change.

DIF: Cognitive Level: Analysis REF: MCS: 389

5. For a multimethod measure, a researcher measures anxiety using a 0- to 10-point verbal scale, the Spielberger State-Trait Anxiety Inventory (0 to 40 points), and syst olic blood pressure readings (80 to 300 points). What are logical strategies for using these three pieces of information gathered from each subject?

(Select all that apply.)

a. Add up all three numbers for a total score. b. Rank all three measures as 1-high, 2-medium, and 3-low, and sum the result. c. Determine the most accurate measurement and give it more weight than the others in a ranking.

d. Determine the most accurate measurement in the first few subject s and then use it exclusively.

e. Report the numbers individually without summing them.

ANS: B, D, E Another effective means of diminishing systematic error is to use more than one measure of an attribute or a concept and to compare the measures. To make this comparison, researcher s use a variety of data collection methods, such as scale, interview, and observation. Cam pbell and Fiske developed a technique of using m ore than one method to measure a concept , referred to as the multimethod-multitrait technique. Multimethod measurement strategies decrease systematic error

by combining the values in some way to give a single observed score of anxiety for each subject. Sometimes, however, it may be difficult logically to justify combining scores from various measures.

DIF: Cognitive Level: Application REF: MCS: 384

6. A researcher administers a test of hopelessness to 50 teen mothers in a continuation high school, in order to norm it for a study planned for the subse quent semester. This norming proce ss is part of the approved research prot ocol. Retesting in two weeks reveals different values for many of the subjects paired tests. What should the researcher do now, and why? (Select all that apply.)

a. Administer the test a third time and see whether there is a trend. The subjects may be becoming more/less hopeless because of an external factor or a Hawthorne effect.

b. Calculate statistical test s to determine whether there are about the same amount s of positive change and negative change for the pooled sample, and whether the me ans are very similar for the two measurements. If so, this represents normal fluctuation of mood.

c. After obtaining IRB approval for study revision, ask several of the 50 subjects with large changes about their recent experiences and discover whether there is an underlying reason for the change.

d. Use the second value, not the first, for all dat a analysis. The subjects have evidently re-examined their feelings and discovered new insights.

e. Consider the multitrait-multimethod technique for this complex concept. A single measurement doesnt seem to be capturing the concept very well.

ANS: A, B, C, E Stability reliability is concerned with the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred t o as test-retest reliability. Test-retest m ay include an additional retest, especially when an unanticipated event has occurred. A third measurement may capture the Hawthorne effect. To capture a complex concept, researcher s use the multimethod-m ultitrait technique, or even a mixed methods design, em ploying a variety of dat a collection methods, such as scale, interview, and observation. These technique s allow rese archers to measure more dimensions of abstract concepts, and the effect of

the systematic error on the composite observed score decreases. Subjects knowledge of a study could influence their behavior and possibly alter the research outcomes. This threatens the validity or accuracy of the measurements. This change could be due to normal random me asurement error. I f so, the sum of the error (the measured change) for all subjects should be zero, and the means on the two days should be the same. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained variance around the mean.

On the other hand, test-retest reliability requires the assumption that the factor being measured has not changed between the measurement points. Many of the phenomena studied in nur sing, such as hope , coping, pain, and anxiety, do change over short intervals. Perhaps true change has occurred.

DIF: Cognitive Level: Analysis REF: MCS: 389

7. A researcher administers a 40-item instrument that measures anxiety of 30 mothers of 9- m onth-old triplets, repeating it in two weeks. Over half of the scores are higher. Why? (Select all that apply.)

a. The mothers are more anxious. The babies are becoming m ore mobile, and the mothers anxiety is well founded.

b. There may have been random error of measurement. The researcher should compare the group means; if they are the same, it is only random error.

c. This may represent systematic error of measurement. d. This may have poor validity for this population and concept. e. This test may have poor reliability for this population and concept.

ANS: A, B, E Stability reliability is concerned with the consistency of repeated measure s of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test -retest reliability. It reveals random error of measurement. This change in scores could be due to normal r andom measurement error. If so, the sum of the error (the measured change) for all subject s should be zero, and the means on the two days should be the same. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained

variance around the mean. Systematic error is not reve aled on test -retest. Te st-retest doe s not me asure validity but reliability. On the other hand, test-retest reliability requires the assumption that the factor being measured has not changed between the measurement points. Many of the phe nomena studied in nursing, such as hope, coping, pain, and anxiety, do change over short intervals.

DIF: Cognitive Level: Analysis REF: MCS: 389

8. A lab scientist is attempting to develop a screening t ool that will detect leukemia before children show any symptom s of the dise ase , because it is most curable in its early stages. The scientist wants a test that will detect all children, whether or not it produces some false positives. What does the rese archer want in terms of that new screening tool? (Select all that apply.)

a. Maximum specificity b. A high LR c. Maximum sensitivity d. A high LR+ e. High interrater reliability ANS: A, D Sensitivity is the ability of a test or diagnostic tool to detect patients with the disease. This is referred to as a true positive. Specificity is the ability of a test or diagnostic tool to detect patients without the disease. This is referred to as a true negative. A test with high sensitivity is very good at identifying the diseased patient. A high positive Likelihood Ratio m ake s a positive diagnosis almost certain. A high negative Likelihood Ratio makes a negative diagnosis almost certain.

Chapter 17. Measurement Methods Used in Developing Evidence-Based Practice Test CHOICE

Bank

MULTIPLE

1. In a study of te asing among third-gr aders, after an intervention on peer interactions, behavioral observers collect the data, rating six behaviors on a 0- t o 4-point scale. The observers are not trained by the same person, and there is no measure of interrater reliability. What is likely to happen?

a. The variable of teasing will not be measured accurately. b. Peer interactions will not be able to be rated. c. The data will have to be scored independently by the researcher. d. Comparison with norms is unlikely.

ANS: A Every variable must be measured in the same way, every time, or the results of the measurement will not be accurate. Measuring physiological variables using observation requires a quality tool for dat a collection and consistent use of this t ool by data collector s. Thus, if the observations in a study are being conducted using multiple data collector s, it is esse ntial that the consistency or interrater reliability of the data collector s be determined.

DIF: Cognitive Level: Application REF: MCS: 413

2. A researcher plans to conduct interviews with the first four participants in a qualitative study, and the n the researcher plans to have an assistant conduct several interviews for the remainder of the interviews. The first thing the researcher does with the research participants is t o perform a pilot interview on one participant and to have the assistant conduct a pilot interview on a different participant, and then they compare notes, discussing the process. Why is this a good idea?

a. This establishes interrater reliability. b. Their styles may differ, and this way they can imitate one anothers styles. c. Pretesting of the interview protocol is essential. d. They can begin the process of data analysis at once.

ANS: C

Interviews involve verbal communication between the researcher and the study participant, during which the researcher acquires information. Interviewers must be trained in the skills of interviewing, and the interview protocol must be pretested.

DIF: Cognitive Level: Application REF: MCS: 422

3. A researcher is interested in discovering whether the topics of written family complaints are shared by the majority of patients families in a major university hospit al, or whether merely a minority of the patients families are disgruntled. The researcher goes throughout the hospital e ach day and hands family members a printed form and pencil and asks them to answer the ten questions, all of which have three to five responses, in return for a $3 off coupon to be used in the hospital cafeteria. What is this printed form called?

a. A questionnaire b. A Likert scale c. A semantic differential scale d. An interview ANS: A Questionnaires are printed self-report forms designed to elicit in formation that can be obtained from a subjects written response s. Likert scale s determine opinion or attitude and contain a number of declar ative statements with a scale after each statement. Semantic differential scales consist of two opposite adjective s with a seven-point scale between them. The subject is to select one point on the scale that best de scribes his or her view of the concept being examined.

Interviews involve verbal communication during which the subject provides information to theresearcher.

DIF: Cognitive Level: Application REF: MCS: 422

4. An out patient being treated in the infusion center for thalassemia is asked to fill out a form about satisfaction with the center, while he wait s for his appointment. The form consists of five questions, each a statement, with six possibilities after it: Strongly Agree, Agree, Slightly Agree, Slightly Disagree, Disagree, and Strongly Disagree. This is an example of which of the following?

a. A semantic differential scale b. A Likert scale c. A questionnaire d. A paper interview ANS: B A Likert scale determines the opinion or attitude of a subject and contains a number of declarative statements with a scale after each statement. The Likert scale is the most commonly use d of the scaling techniques in nursing and health care studies. Response choices in a Likert scale most commonly address agreement, evaluation, or frequency. Agreement options may include st atements such as strongly agree, agree, uncertain, disagree, and strongly disagree.

DIF: Cognitive Level: Application REF: MCS: 430

5. A researcher constructs a sem antic differential scale that will me asure a t opic about which people express extreme responses. He pilot s it and, at the same time, asks a psychometrician to give his opinion on the scale.

The psychometrician suggest s that the researcher edit the scale, so that it has some questions for which a 1 or 2 would be a positive finding, and some que stions for which a 1 or 2 would be a negative finding. The researcher edits the scale and finds that subjects responses are not quite as extreme as they were originally.

What should the researchers response be?

a. Resentment. The new scale is giving we aker result s, and its analysis will not be able t o show statistical significance unless the projected sample size is increased.

b. Bewilderment. The scale is exactly the same; the items were merely rearranged. There is nothing that explains this change.

c. Gratitude. The new scale measures the conce pt better because the subjects are thinking about the individual items instead of marking extremes automatically.

d. Annoyance. The researcher has probably inadvertently reworded some of his original items, accounting for the less extreme values.

ANS: C

A semantic differential scale consists of two opposite adjectives with a se ven-point scale between them. The subject is to select one point on the scale that best de scribes his or her view of the concept being examined.

The scale is designe d to measure the connotative meaning of the conce pt to the subject. Although the adjectives may not seem to be particularly related to the concept being examined, the technique can be used to distinguish varying degrees of positive and negative attitudes toward a concept . In a semantic differential scale, values from 1 t o 7 are assigned to each of the spaces, with 1 being the most negative response and 7 the most positive. Placement of negative responses to the left or right of the scale should be randomly varied to avoid global responses (in which the subject places checks in the same column of each scale).

DIF: Cognitive Level: Analysis REF: MCS: 431

6. A nurse believes that patient acuity is a poor measure of patient fragility. Conse quently, he and another nurse construct an instrument that measures patient fragility. In what order should the various steps of scale testing, conceptual definition, scale construction, instrument validation, and qualitative exploration occur?

a. Scale testing, qualitative exploration, scale construction, conceptual definition, instrument validation

b. Conceptual definition, qualitative exploration, scale construction, scale testing, instrument validation

c. Scale construction, conceptual definition, instrument validation, scale testing, qualit ative exploration

d. Instrument validation, qualit ative exploration, scale construction, conce ptual de finition, scale testing

e. Qualitative explor ation, scale testing, scale construction, conceptual definition, instrument validation

f. Conceptual de finition, instrument validation, scale construction, scale testing, qualit ative exploration ANS: B In classic test theory, the following proce ss is use d to construct a scale: conceptual definition, scale design, item review, preliminary item tryouts, field testing, item analyses, selection of items to retain, conduct validity studies, reliability estimations, compiling of norms. Other

methods vary. However, the essential thing is to identify the concept and then proceed with design, either by quantitative or qualitative methods, following with construction, some form of testing for feasibility, and then reliability and validity determination.

DIF: Cognitive Level: Application REF: MCS: 442-443

7. A university that is publicly funded is located in a st ate that is experiencing serious budget shortfall, and the budget has been halved. The universitys 32 de partments are aske d to list each of their program s on an index card, resulting in 90 cards. A panel comprise d of the president, pr ovost, and five de ans each independently arranges the cards int o categories of 3 essential, 7 highly de sirable , 15 very desirable, 40 mainstream, 15 expendable , 7 immediately expendable, and 3 targeted elimination. This is an example of which methodology?

a. Delphi technique b. Semantic differential scale c. Likert scaling d. Q-sort method ANS: D Q-sort methodology is a technique of comparative rating that preserves the subjective point of view of the individual. Cards are use d to categorize the importance placed on various words or phrase s in relation t o the other words or phr ase s in the list. Each phr ase is place d on a separ ate card. The number of cards should range from 40 to 100. The subject is instructed to sort the cards into a de signated number of pile s, usually 7 t o 10 pile s ranging from the m ost to the le ast im portant . The subject is limited in the number of cards that may be place d in each pile, with few at the ends and many in the center, mimicking the normal curve.

DIF: Cognitive Level: Application REF: MCS: 434

8. How would a rating scale item be worded? a. I can be alone for hours and not feel lonely: Strongly Agree, Agree, Undecided, Disagree, Strongly Disagree.

b. When I walk one block, I feel: ( a) healthy and invigor ated, (b) no different from the way I ordinarily feel, (c) pleasantly tired, (d) exhausted and out of breath.

c. Place a vertical line intersecting this line to show what your anxiety is; the scales ends are 0 for No Anxiety at All, and 10 for The Worst Anxiety I Have Ever Experienced.

d. Rank your boss from 1 to 7 on the following quality: sensitivitycallousness.

ANS: B The Likert scale determines the opinion or attitude of a subject and contains a number of declarative statements with a scale after each statement. A r ating scale lists an ordered series of categories of a variable that are assumed to be based on an underlying continuum.

The Visual Analog Scale (VAS) is frequently used in healt h care research since it is easy to construct, administer, and score. VASs can be administered using a drawn, printed, or computer- generated 100-mm line.

The research participant is aske d to place a mark through the line to indicate the intensity of the sensation or stimulus. A semantic differential scale consists of two opposite adjectives with a seven-point scale between them.

DIF: Cognitive Level: Application REF: MCS: 430

9. A Canadian researcher has had a tool published in English. The tool examines the embedded meanings of life in a country that has colonial root s but still maintains allegiance to the mother country. There is a demand for use of the tool in French-speaking Canadian cities. Which is the type of translation that is m ost appropriate for this tool?

a. Pragmatic translation b. Aesthetic-poetic translation c. Ethnographic translation d. Linguistic translation ANS: C Four type s of translations can be performed: pr agmatic translations, ae sthetic-poetic translations, ethnographic translations, and linguistic translations. Pragmatic translations communicate the

content from the source language accur ately in the target language. The primary concern is the information conveyed. An example of this type of translation is the use of translated in structions for assembling a computer. Aesthetic-poetic translations evoke moods, feelings, and affect in the target language that are identical to those evoked by the original material. In ethnographic translations, the purpose is to maintain meaning and cultur al content. In this case , translator s must be familiar with both language s and cultures.

Linguistic translations strive to present gr ammatical forms with equivalent meanings. Translating a scale is generally done in the ethnographic mode.

DIF: Cognitive Level: Application REF: MCS: 445 MULTIPLE RESPONSE

1. Which of the following are physiological measures? (Select all that apply.) a. A subjects report of episodes of tachycardia per day b. Score on the Mini Mental Status Exam c. Pulse rate as displayed on an ICUs monitor d. Serum sodium e. Use of a tuning fork to measure bone conduction hearing loss ANS: A, C, D, E Physiological measures include two categories, biophysical and biochemical measures. For example, biophysical measure s might include the use of the stethoscope and sphygmomanometer to measure blood pressure and a biochemical measure might include the laborat ory value for total chole sterol. Self-report has been used effectively to obt ain physiological inform ation and m ay be particularly useful when the subjects are not in closely m onitored settings such as hospitals, clinics, or rese arch facilities. For some variables, self-report may be the only means of obtaining the information. Such m ay be the case when study participants experience a physiological phenomenon that cannot be observed or measured by others.

DIF: Cognitive Level: Analysis REF: MCS: 412

2. Which of the following would be non -physiologic measures that could be used in nursing research?

(Select all that apply.)

a. Surveys that determine the percentage of counseling appointments that have decreased psychological pain in the 72 hours following each appointment

b. Photographs of chimpanzee chromosomes c. Observation ratings of the depth of a pressure ulcer d. Surgical interventions intended to ablate pain e. Opinion surveys of what patients want to have included in their discharge teaching after outpatient surgery ANS: A, E Physiological measures include two categories: biophysical and biochemical measures. For example, biophysical measure s might include the use of the stethoscope and sphygmomanometer to measure blood pressure and a biochemical measure might include the laborat ory value for total chole sterol. Self-report has been used effectively to obt ain physiological inform ation and m ay be particularly useful when the subjects are not in closely m onitored settings such as hospitals, clinics, or rese arch facilities. For some variables, self-report may be the only means of obtaining the information. Such m ay be the case when study participants experience a physiological phenomenon that cannot be observed or measured by others.

DIF: Cognitive Level: Application REF: MCS: 412

3. Which of the following are direct measures? (Select all that apply.) a. The patients radial pulse rate b. The dimensions in centimeters of a decubitus ulcer c. The nurses observations of an infants apparent pain d. The physicians measure of the patients deep tendon reflexes e. The patients estimate as to whether his lithium level is within therapeutic range f. The mothers report of her toddlers anxiety level before a blood draw g. The patients serum serotonin levels

ANS: A, B, D, G Direct measures are more accurate because there is an objective measurement of the study variable. For example, patients might be aske d to report any irregular heartbeats during waking hours over a 24-hour period, which is an indirect measurement of heart rhythm, and e ach patients he art could be monitored with a Holter monitor over the same 24 -hour timefr ame, which is a direct measurement. Whenever possible, researchers usually select direct measures of their study variable s due to the accuracy and precision of these measurement methods. However, if a direct measurement method does not exist, an indirect measurement method could be used in the initial investigation of a physiological variable.

DIF: Cognitive Level: Application REF: MCS: 413-414

4. In an observational study of manifest ations of various categories of sundowning behavior in hospitalized super-elders, which of the following are true? (Select all that apply.)

a. Checklists based on a rating scale would be helpful ways to record behaviors. b. Rating scales of 1-absent, 2-slight, 3-moderate, and 4-severe could be used. c. A category system should be developed before the study begins. d. The patients assessment of whether or not he is sundowning is valuable. e. There should be no overlap of the categories confused, placid and confused, agitated. f. Research assistants observing the patients should be given similar training. g. Observations should be made under similar circumstances.

ANS: A, B, C, E, F, G The first step in a structured observation is to de fine carefully what specific behavior s or events are to be inspected or observed in a study. From that point, researcher s determine how the observations are to be made, recorded, and coded. In most cases, the research team will develop an observational checklist or category system to direct the collecting, organizing, and sorting of the specific behaviors or events being observe d. The observational categories should be mutually exclusive. A numerical value is assigned to each category; and the fine ness of the distinctions between categories varies with the scale, m aking this one of the crudest forms of scaling

technique. If the observations in a study are being conducted using multiple dat a collector s, it is essential that the consistency or interrater reliability of the data collectors be determined.

DIF: Cognitive Level: Application REF: MCS: 421

5. An outpatients daughter has been using a diary to track the appear ance of her mothers decubitus ulcer when the daughter performs the daily dre ssing change. The patient has been newly consented for participation in the trial of a new product presumed to accelerate healing and prevent infection. The researcher instructs the daughter in use of the ne w product and the use of a scale for tracking the ulcers healing. Scale items are change in total area (width times depth), drainage color, surrounding tissue integrity, pain, and smell. What are the advantages of using a scale instead of a diary? (Select all that apply.)

a. It reduces all items to a Likert scale. b. It makes wound care easier. c. It forces a level of precision that may or may not be present in a diary. d. It produces numerical dat a that the rese archer can easily analyze in order to provide evidence of difference between the new method and the old method.

e. It makes sure that subjects all will have daily recordings of the variable s the researcher intends to measure.

ANS: C, D, E A rating scale allows the observer to rate the behavior or event on a scale . Scales, a form of self- report, are a more precise means of measuring phenomena than are questionnaires. The m ajority of scales have been develope d to measure psychosocial variables. Howe ver, self-reports can be obtaine d on physiological variables such as pain, nause a, or functional capacity by using scaling technique s as discussed e arlier in this chapter. This method provides m ore information for analysis than doe s the use of dichotomous data, which indicate only that the be havior either occurred or did not occur. Scales, another form of self-reporting, are more precise in measuring phenomena than are questionnaires and have been developed to measure psychosocial and physiological variables. The types of scale s include the rating scale, Likert scale, semantic differential scale, and the visual analog scale.

DIF: Cognitive Level: Analysis REF: MCS: 422

6. Which of the following are true statements regarding the disadvant ages of observational methods?

(Select all that apply.)

a. They may increase subject reactivity. b. When a single interrater is used and observations are opposite, there is no way to resolve the conflict, since each is equally correct.

c. They may be used for both quantitative and qualitative research. d. They are more subjective than other types of measurements. e. They allow real-time capture of data. f. They are invariably subject to skepticism unless verified in some manner.

ANS: A, D, F Observational measurement is the use of unstructured and structured inspection t o gauge a study variable.

Although me asurement by observation is m ost common in qualitative research, it is used to some extent in all types of studies. The rese archer must be cle ar on what is to be observed. The rese archer must ensure that each variable is observed in a similar manner in each instance, so much attention must be given to training data collector s, e specially when the observations are complex and examined over time. Pilot-testing and assurance of interrater reliability are essential. Observational measurement tends to be more subjective than other types of measurement and is thus often seen as le ss credible, but in many cases it is the only possible way to obtain important evidence for practice.

DIF: Cognitive Level: Analysis REF: MCS: 421

7. The principal disadvantages of administering open-ended questions are which of the following?

(Select all that apply.)

a. They are difficult to construct. b. They are time-consuming to analyze. c. They are impractical for use with large samples. d. They cannot produce exhaustive, exclusive answers. e. They force answers.

f. They can be difficult to interpret.

ANS: B, C, F Data from open-ende d questions are often difficult to interpret, and content analysis m ay be used to extract meaning. Open-ended questionnaire items are not advised if data are being obtained from large samples.

DIF: Cognitive Level: Analysis REF: MCS: 425

8. The principal disadvant ages of using a subjects diary either instead of interview dat a or t o supplement interview data would be which of the following? (Select all that apply.)

a. Subjective perception at the time of the event is retrievable. b. Private and clandestine topics that have previously been accessible may be obtained through diaries.

c. Diaries contain more truthful information than do other sources. d. No contact with the subject is necessary. e. Diaries may be used without consent. f. Information obt ained fr om a diary is thought to be more accurate than that obtaine d from pure recall.

ANS: A, B, F A diary is a recor ding of event s over time by an individual t o document experiences, feelings, or be havior patterns. Diaries are also called logs or journals and have been used since the 1950s to collect data for rese arch from a variety of populations including children, the acute and chronically ill, pregnant women, and the elderly.

A diary, which allows recording shortly after an event, is thought t o be more accurate than obtaining the information through recall during an interview. In addition, the reporting level of incidents is higher, and one tends to capture the participants immediate perception of situations. The diary technique give s nur se researchers a me ans t o obt ain data on topics of particular interest within nursing that have not been acce ssible by other means.

DIF: Cognitive Level: Analysis REF: MCS: 437

9. Pre-existent dat abase s used in nursing research for secondary analysis contain dat a of different sorts. What are these? (Select all that apply.)

a. Data collected internally by a health care institution for quality assurance or other review of its processes

b. Data collected by unknown people for unknown reasons c. Data collected by governmental and private agencie s, such as insur ance companies, external to a health care institution

d. Records locked by the courts e. Data collected by another researcher for a previous study ANS: A, C, E Nurse researchers are expanding their use of data from existing databases to answer their research questions and test their research hypothese s. Health data is usually categorized into secondary dat a and administrative data. Secondary data are those dat a collected during a previous research study.

Administrative data are collected within clinical agencies; obtained by national, st ate, and local profe ssional organizations; and collected by federal, state, and local agencies.

DIF: Cognitive Level: Analysis REF: MCS: 439

10. A researcher isnt sure whether 60 -year-old women, the target population of her research, will underst and the wording of a questionnaires 50 items asse ssing knowledge of sympt oms of myocardial infarction in women. Consequently, the researcher might logically decide to do which of the following? (Select all that apply.)

a. Provide a small glossary defining some of the more technical terms on the questionnaire.

b. Conduct a pilot of the questionnaire. c. Use a Q-sort methodology to prioritize the essential questions and decrease the questionnaire down to 20 items.

d. Ask a content expert to evaluate the readability of the questionnaire. e. Arrange for se veral radio and TV public-service announcements, informing the public of the symptoms of myocardial infarction in women.

ANS: B, D Once the research team has satisfact orily develope d the interview protocol, they must pretest or pilot -test it, using subjects similar to those who will be include d in their study. Pilot -testing will allow them to identify problems in the design of que stions, sequencing of questions, or procedure for recording responses.The readability level of an instrument is a critical factor when selecting an instrument for a study. Regardless of how valid and reliable the instrument is, it cannot be use d effectively if study participant s do not underst and the items. Calculating readability is relatively easy and can be performed in a fe w minutes. Many word processing program s and computerized grammar checkers will report the readability level of written material.

Provision of a glossary is counter to the intent of the que stionnaire, which is to assess knowledge of symptom s.

Arranging for several radio and TV announcement s will also undermine the purpose of the intent of the questionnaire. Q-sort methodology is a technique of com par ative rating that preserves the subjective point of view of the individual. Using a Q-sort to decrease the number of questions will address length, not readability.

DIF: Cognitive Level: Analysis REF: MCS: 433

11. Which of the following constructs would be inappropriate to measure with a visual analogue scale?

(Select all that apply.)

a. Dichotomous variables b. Blood pressure c. Visual acuity d. Anxiety e. Playfulness ANS: A, B, C In an e ffort to resolve this problem, the visual analog scale was developed t o measure magnitude, strength, and intensity of the individuals sensations or feelings. The visual analog, sometimes spelled analogue, scale (VAS) is referred to as magnitude scaling. This technique seems to provide interval-level data, and some researchers argue that it provides ratio-level data. It is particularly useful in scaling stimuli. This scaling technique has been used to measure pain,

mood, anxiety, alertness, craving for cigarettes, quality of sleep, attitudes toward environmental conditions, functional abilities, and severity of clinical symptom s. The stimuli must be defined in a way that the subject clearly understands. Only one major cue should appear for e ach scale . The scale is a line 100 mm in length with right-angle stops at each end. Bipolar anchors are placed beyond each end of the line.

DIF: Cognitive Level: Application REF: MCS: 433

12. Why is the visual analogue scale (VAS) used so frequently in health care research? (Select all that apply.) a. Validity is the same, regardless of how the visual analogue scale is used. b. It elicits nominal-level data. c. It is easy for clients to understand. d. It is more sensitive to small changes than are numerical and rating scales. e. It requires a minimum of translation to be used in languages other than English. f. It is easy to administer and score.

ANS: C, D, E, F The visual analog scale (VAS) is a magnitude scale particularly use ful in scaling stimuli. Measured stimuli must be defined in a way that the subject cle arly under stands. Only one m ajor cue should appear for each scale. The scale is a line 100 mm in length with right-angle st ops at e ach end. Bipolar anchor s are placed beyond each e nd of the line. The VAS is frequently used in he alth care research since it is easy to construct, administer, and sc ore.

The VAS is more sensitive to small changes than numerical and rating scales are and can discriminate between two dimensions of pain. Validity of the VAS has most comm only been determined by comparing the VAS scores with other measure s of a concept . For example, Winkelman, Norma, Maloney, and Kle ss (2008) compared VAS scores with dermatome assessment in measuring pain during labor. The following study excerpt describes the agreement between these two measures of pain in laboring women who received an epidural analgesia.

DIF: Cognitive Level: Analysis REF: MCS: 434

13. Why might a researcher use a structured interview rather than an unstructured one? (Select all that apply.)

a. The desired data for this interview is quantitative. b. Interview time is limited. c. The researcher is collecting only demographic data for the study. d. The research subjects are confused and garrulous. e. Other data were gathered previously, using an unstructured interview.

ANS: A, C, E Structured interviews are verbal interactions with subjects that allow the researcher to exercise increasing amounts of control over the content of the interview to obtain e ssential data for a study. The rese archer designs the que stions be fore data collection begins, and the order of the que stions is specified. In some case s, the interviewer is allowe d to further explain the meaning of the question or modify the way in which the question is asked so that the subject can better underst and it. In m ore structured interviews, the interviewer is required to ask the que stion precisely as it has been de signed. If the subject does not understand the question, the interviewer can only repeat it. The subject may be limited to a r ange of response s previously developed by the researcher, similar to those in a questionnaire. If the possible responses are lengthy or complex, they may be printed on a card so study participant s can review them visually before selecting a response . Qualitative research alm ost invariably uses interviews that are unstructured or semi-structured. Unstructured interviews consist of one or two global open-ende d questions de velope d to gain quality, in -depth data from a limited number of subjects. They are completely controlled by the subject.

DIF: Cognitive Level: Synthesis REF: MCS: 422

14. Which of the following are example s of items that could be included in a visual analogue scale? (Select all that apply.)

a. Stronger than Hercules, weak as a kitten b. Passive, nonassertive c. Strongly agree, uncertain

d. Stunningly beautiful, repulsively ugly e. Perfect, wrong in all respects ANS: A, B, E The visual analog scaling technique has been used to measure pain, mood, anxiety, alertness, craving for cigarettes, quality of sleep, attitude s toward environmental conditions, functional abilities, and severity of clinical symptom s. The stimuli must be defined in a way that the subject clearly underst ands. The scale is a line 100 mm in length with right-angle stops at each end.

Bipolar anchor s are placed beyond each end of the line . These should be opposite and extreme. DIF: Cognitive Level: Application REF: MCS: 433

15. A researcher plans to administer a valid research tool in another language. What must be done in order to establish its validity in the second language? (Select all that apply.)

a. Reliability testing b. Testing and then back-translating with different translators c. Analysis of values obtained with both scales d. Testing in both languages with bilingual subjects e. Concept analysis ANS: B, C, D Translating an instrument from the original language to a target language is a complex process. One strategy for translating scales is to translate from the original language to the target language and then back-translate from the target language to the original language by using translators not involved in the original translation.

Discrepancies are identified, and the procedure is repeated until troublesome problems are resolve d. After this procedure, the two versions are administered to bilingual subjects and scored by standard procedures. The resulting sets of scores are examined to determine the extent to which the two versions yield similar information from the subjects. This procedure assumes that the subjects are equally skilled in both languages.

Chapter 18. Critical Appraisal of Nursing Studies Test

Bank

MULTIPLE

CHOICE

1. A reader of qualitative research note s that a study is identified as Heide ggerian phenomenology. The purpose of the study was t o explore the lived experience of the long -term process of separating from a longtime partner and subsequently m arrying another person, and t o elicit descriptions of the experiences meaning. This topic is unexplored in the literature. The sample of 21 was randomly selected from 68 volunteers. Participants interviews were tape- recorde d and transcribed, and then coded by two r aters, whose inter-rater reliability was reported as 95%. The findings reve aled that there was a lengthy period of adjustment following separ ation, and that participant s filled this time by denying permanency, creating possibilities, appreciating silence , developing personal strengths, trusting, developing skepticism, st arting a ne w MCS :, and maintaining mental boundarie s. The m ost immediate evaluative critique point about this article relates to which the following?

a. It is not clear what the findings contribute to the current body of knowledge. b. The development and implementation of the study methodology is not congruent with its philosophical foundation.

c. Tape-recording, transcription, and coding by two r aters is not likely to capture the e sse nce of this experience, without video-recording and participant observation.

d. The findings do not seem to be a credible reflection of reality.

ANS: B Critical appraisal is not complete with making judgments about the validity of the study. Synthesis of the evaluative criteria for qualitative studies can be reframed as philosophical congruence, methodological coherence, intuitive comprehension, and intellectual contribution. Philosophical congruence is the problem here: parts of the de velopment and implementation of the study (sample selection, dat a analysis) are not congruent with phenomenologic enquiry.

DIF: Cognitive Level: Comprehension REF: MCS: 451

2. A nurse reader of qualitative research notes that a study is identified as grounded theory research. The topic of study is how women leave a violent relationship. The nurse reader herself has never been in a physically abusive relationship. She has, however, cared for several patient s who have told her their personal stories, and she has a cousin who was in a physically abusive relationship for se veral months. Because of this, she has an immediate understanding and finds the results credible. What aspect of the evaluative criteria for qualitative research does this reflect?

a. Intellectual contribution b. Intuitive comprehension c. Methodological coherence d. Philosophical congruence ANS: B Critical appraisal is not com plete with making judgment s about the validity of the study. Synthe sis of the evaluative criteria for qualitative studie s can be reframed as philosophical congruence , methodological coherence, intuitive comprehension, and intellectual contribution. This particular phenomenon relates to intuitive comprehension.

1. Philosophical congruence: Were the development and implementation of the study congruent with the philosophical foundation of the study?

2. Methodological coherence: Did the data collection, analysis, and interpretation processes fit together to form a coherent approach to address the research problem?

3. Intuitive comprehension: Do the findings provide a credible reflection of reality and expand the readers comprehension of the study topic? If so, how can the findings be used in nursing practice?

4. Intellectual contribution: What do the findings contribute to the current body of knowledge?

5. State the conclusion of the critical appraisal of the study.

DIF: Cognitive Level: Comprehension REF: MCS: 451

3. What is the most accurate statement related to a studys strengths? a. A studys strengths always involve a level of complexitymultiple research questions, many variables, many references.

b. A studys strengths are essentially the elements of the study that the researcher completed in accordance with the design of the study.

c. A studys strengths are determined by whether the research results are statistically significant or not.

d. A studys strengths are determined by the number of times the article is cited by other authors.

ANS: B The next step in critically appr aising a quantitative study requires determining the strengths and weaknesses of the study. To determine the strengths and weakne sse s of a study, the reader must have knowle dge of what each step of the research process should be like from expert sources.

Then the elements of the re search process are compared with the actual study steps. One determines whether the researcher followed the rules for an ideal study.

DIF: Cognitive Level: Analysis REF: MCS: 458

4. In deciding whether a framework is suited to a study, what is the principal que stion the reader must answer?

a. Is a conceptual map provided? b. Is this the best framework for this study? c. Does the framework specify the study variables? d. Is this a theory or merely a framework?

ANS: B The questions a reader must ask are presented in this order:

1. Is the framework prese nted with clarity? If a model or conceptual m ap of the framework is present , is it adequate to explain the phenomenon of concern?

2. Is the framework linked to the research purpose? If not, would another framework fit more logically with the study?

3. Is the framework related to the body of knowledge in nursing and clinical practice?

4. If a proposition or relationship from a theory is to be tested, is the proposition clearly identified and linked to the study hypotheses DIF: Cognitive Level: Analysis REF: MCS: 458

5. Why is the first prerequisite for appraising qualitative studies an appreciation for the philosophical foundation of qualitative research?

a. Understanding the research require s a detailed under standing of e ach qualit ative methodology.

b. Qualitative rese arch is not based on truth; it takes work for the reader to get past this stumbling block.

c. There is no common ground am ong the qualit ative methods. Each requires individual study before reading a research report can be attempted.

d. All qualitative rese arch has slightly different ground rules. Without an understanding of the philosophy of the method, appraisal is unfair.

ANS: D The first prerequisite for appraising qualitative studies is an appreciation for the philosophical foundation of qualitative research. Qualitative re searchers design their studie s to be congruent with one of a wide range of philosophies, such as phenomenology, sym bolic interactionism, and hermeneutics, each of which espouse s slightly different appr oache s to gaining new knowledge. Although unique, the qualitative philosophies are similar in their view of the uniqueness of the individual and the value of the individuals perspective. Without an appreciation for the philosophical perspective supporting the study being critically appraised, the appraiser may not appropriately apply the standards of rigor consistent with that perspective.

DIF: Cognitive Level: Analysis REF: MCS: 463 MULTIPLE RESPONSE

1. What must the person critically appraising a qualitative research report posse ss as prerequisites, in order to begin the process? (Select all that apply.)

a. Experience in performing qualitative data collection or analysis b. An empathic point of view toward the participants perspectives and reported experiences

c. A basic knowledge of different philosophical perspectives d. The willingness to le arn about the philosophical per spective supporting the study, in order to apply the standards of rigor that are consistent with that perspective

e. Previous experience in critically appraising qualitative research ANS: B, C, D Prerequisites of philosophical foundation, type of qualitative study, and openness to study participants direct the implementation of the following guidelines for critically appraising qualitative studie s. Without an appreciation for the philosophical perspective supporting the study being critically appr aised, the appraiser may not appropriately apply the standards of rigor consistent with that perspective. A basic knowledge of different qualitative approache s is as e ssential for appr aisal of qualitative studies as knowledge of quantitative research de signs is for appr aising quantitative studies. Appreciating philosophical perspectives and knowing qualitative approache s are both superficial, however, without empathy for the participants perspective.

Empathy cre ates an openne ss to knowing a participant within a natur alistic holistic framewor k. One does not need experience in performing qualitative data collection or analysis, nor does one need to have previous experience in critically appraising qualitative research in order to perform this: one must start somewhere.

DIF: Cognitive Level: Analysis REF: MCS: 463

2. Why is identifying the steps of the research proce ss the fir st step in the critical appraisal proce ss for quantitative research? (Select all that apply.)

a. Identifying the steps in the process indicates that the reader knows what these are. b. Identifying the steps is more important than understanding.

c. Identifying the steps implies that the reader understands everything in the research report.

d. Identifying the steps indicates that the reader comprehends the conce pts in the research report.

e. Identifying the steps of the research process implie s under standing the terms the researcher uses in the research report.

ANS: A, D, E The critical appraisal pr ocess for quantitative research include s three steps: (1) identifyi ng the steps of the research process, (2) determining study strengths and we aknesses, and (3) evaluating the credibility and meaning of a study to nur sing knowle dge and practice. These steps occur in seque nce, vary in depth, and presume accomplishment of the preceding steps. However, an individual with critical appr aisal experience frequently performs several steps of this proce ss simultane ously. Initial attempts t o comprehend research articles are often frustrating because the terminology and stylized manner of the report are unfamiliar.

Identification of the steps of the research proce ss in a quantitative study is the fir st step in critical appraisal. It involve s understanding the terms and concepts in the report, as well as identifying study elements and grasping the nature, significance, and meaning of these elements.

DIF: Cognitive Level: Analysis REF: MCS: 454

3. What happens during the second step of the quantit ative critical appraisal proce ss, in the case in which the reader determines study strengths and weaknesses of a particularly weak research report?

a. The reader discovers what elements of the study are in what locations of thereport. b. The reader constructs a global appraisal of the researchs lack of rigor. c. The readers task is to analyze the quality of the individual parts of a re search report. This inevitably pr oduce s an impression not only of what the research did not do, but also of what should have been done.

d. The reader is required to examine each part minutely; this leads to an appreciation of what the researcher did well.

e. The reader evaluates the goodness of the study.

ANS: C, D The critical appraisal proce ss for quantitative research includes three steps: (1) identifying the steps of the research process, (2) determining study strengths and weaknesses, and (3) evaluating the credibility and meaning of a study to nursing knowledge and practice. Identification of the steps of the re search process in a quantitative study is the fir st step in critical appraisal. The next step in critically appr aising a quantitative study requires determining the strengths and weaknesses of the study. To do this, the reader must have knowledge of what e ach step of the rese arch proce ss should be like from expert sources, such as this textbook and other research sources. Then the ideal ways to conduct the steps of the rese arch proce ss are compared with the actual study steps. During this comparison, the reader examines the extent to which the researcher followed the rules for an ideal study.

DIF: Cognitive Level: Analysis REF: MCS: 454

4. What are the true statements related to evaluation for quantitative research appraisal? (Select all that apply.)

a. Evaluation cannot be performed without having com pleted the previous two steps of the appraisal process.

b. Evaluation draws no conclusions about the merit of a particular research study. c. Evaluation critically analyzes the parts of a study and point s out their deficits in com parison to an ideal.

d. True evaluation implies an examination of related studie s, so as to assess significance, credibility, and believability.

e. Evaluation includes an asse ssment of the rese archs contribution to nursing knowledge.

f. Evaluation plus focused literature review essentially equals concept clustering.

ANS: A, D, E, F The critical appraisal process for quantitative research includes three steps: (1) identifying the steps of the research proce ss, (2) determining study strengths and we akne sse s, and (3) evaluating the credibility and meaning of a study to nursing knowledge and pr actice. During the second step of this proce ss, not the evaluation, the reader examines the extent to which the researcher

followed the rules for an ideal study. Evaluation involves determining the validity, credibility, significance, and meaning of the study by examining the links between the study process, study findings, and previous studies.

The steps of the study are evaluated in light of previous studie s, such as an evaluation of present hypothese s based on previous hypot heses, present design based on previous de signs, and prese nt methods of measuring variables based on previous methods of measurement. The findings of the present study are also examined in light of the findings of previous studies. Evaluation builds on conclusions reached during the first two stage s of the critical appraisal so the credibility, validity, and meaning of the study findings can be determined for nur sing knowledge and practice.

DIF: Cognitive Level: Synthesis REF: MCS: 454

5. Which of the following represent the specific attributes that qualitative research must posse ss in order to be evaluated as acceptable? (Select all that apply.)

a. Intellectual contribution b. Methodological congruence c. Evaluative strength d. Philosophical congruence e. Suspension of disbelief f. Intuitive comprehension ANS: A, B, D, F Critical appraisal is not com plete with making judgments about the validity of the study. Synthe sis of the evaluative criteria for qualitative studie s can be reframed as philosophical congruence , methodological coherence, intuitive comprehension, and intellectual contribution.

DIF: Cognitive Level: Comprehension REF: MCS: 465

6. What would be exemplified by poor overall flow of logic in the study, in terms of the second step of critical appraisal? (Select all that apply.)

a. The title of the study mentions the effect of, but the study de sign is simple descriptive.

b. There was a 60% dropout; nonetheless, the researchers claimed that the sample was representative.

c. Statistical analyse s used are all coherent with the variables levels of measurement.

d. The study framework is gratuitous. It does not, in the slightest, help to explain the relationship between the principal study variables.

e. The problem statement and the purpose of the study arent closely related. It seems like a big leap to get from the problem to the gap, and to the purpose.

ANS: A, B, D, E The reader must examine the logical links connecting one study element with another. For example , the problem needs t o provide background and direction for the statement of the purpose. In addition, you need to examine the overall flow of logic in the study. The variable s identified in the study purpose need to be consistent with the variable s identified in the research objectives, que stions, or hypothese s. The variables identified in the rese arch objectives, questions, or hypotheses need to be conceptually defined in light of the study framewor k. The conce ptual definitions pr ovide the basis for the development of oper ational definitions. The study design and analyse s need t o be appropriate for the investigation of the study purpose, as well as for the specific objectives, que stions, or hypothe ses. Most of the limitations or weaknesses in a study result from breaks in logical reasoning.

DIF: Cognitive Level: Evaluation REF: MCS: 458

7. To what do the logic and form of the findings refer in qualitative critique? (Select all thatapply.) a. There were numerous cross-checks, to ensure that what participants reported was objectively true.

b. The elements of the rese arch were present in the research report and located so that the reader could easily find them.

c. The readers underst anding of the phenomenon was better after reading the study than it had been beforehand.

d. The findings were presented in a way that made sense, taken as a whole.

e. The way the report was presented was congruent with its purpose, methods, and findings. f. There was a clear se nse that the themes and essences emanated from the statements and perceptions of real people.

ANS: B, C, D, E, F The logic and form of the findings are critical to the appraisal of the study. (1) Were readers able to hear the voice of the participants and gain an under standing of the phenomenon studied? (2) Were readers able to identify easily the elements of the research report? (3) Did the overall prese ntation of the study fit its purpose , method, and findings? (4) Was there a coherent logic to the presentation of findings?

DIF: Cognitive Level: Analysis REF: MCS: 465

8. In which ways are critical appraisal of quantitative research and critical appraisal of qualitative research the same? (Select all that apply.)

a. Both are concerned with how well the author has established the objective truth of the data.

b. Both must begin with an appreciation for the philosophical foundation of theresearch. c. Both define rigor in the same way. d. Both are designed to provide some evaluations about the intrinsic worth of theresearch. e. In both, the elements of the research report are identified. f. Both examine how well measurements in the data collection phase have maintained their precision.

ANS: B, D, E The first prerequisite for appraising qualitative studies is an appreciation for the philosophical foundation of qualitative research. Qualitative re searchers design their studie s to be congruent with one of a wide range of philosophies, such as phenomenology, sym bolic interactionism, and hermeneutics, each of which espouse s slightly different approache s to gaining new knowledge; quantitative research espouse s and follows the tenets of the scientific method. Nonetheless, an

appreciation for each is foundational to the critique process. Phenomenologists agree that there is not a single reality; each individual has his or her own reality. Reality is considered subjective , and as a result, unique t o the individual, and, consequently, objective truth need not be checked, since the perception of the individual is that persons truth. Quantitative methods check truthfulness of data. Rigor is defined in quantitative research as in qualitative rese arch, rigor is particular to each different method but, overall, implie s adherence to that method. Both types of critical appraisal begin with identification of the elements of the research report.

Chapter 19. Evidence Synthesis and Strategies for Implementing Evidence-Based Practice Test

Bank

MULTIPLE

CHOICE

1. Which is the most accurate statement about translational research? a. Translational re search focuses on providing literal and readable translations of re search in one of the primary 15 languages in which research is read.

b. Translational research is essentially evidence-based practice. c. Translational re search attempt s to discover something useful in basic scientific discoveries.

d. Translational research is applied research based on basic research knowledge.

ANS: D Translational rese arch is an evolving concept that is define d by the NIH as t he translation of basic scientific discoveries into practical applications. Basic research discoveries from the labor atory setting need to be tested in studies with hum ans. In addition, the outcomes from human clinical trials need to be adopted and maintained in clinical practice. Translational research is being encour aged by both medicine and nursing to increase the implementation of evidence-based interventions in practice and to determine if these interventions are effective in producing the outcomes desired in clinical practice.

DIF: Cognitive Level: Analysis REF: MCS: 503

2. Nursing is said t o be a science and an art. If best research e vidence represent s the science of nur sing, what represents the art?

a. Clinical expertise b. Patient values and needs c. Synthesis of best research evidence d. Eye-hand coordination ANS: A Evidence-base d pr actice (EBP) is the conscientious integration of best re search evidence with clinical expertise and patient value s and needs in the delivery of quality, cost -effective he alth care. Be st research evidence is largely fact-base d and is intended to produce consistent interventions, usually of a technical nature. Patient values and needs emanate from the patient. Clinical expertise provides the art of nursing practice.

DIF: Cognitive Level: Comprehension REF: MCS: 468

3. How is best research evidence produced? a. By the conduct and synthesis of numerous high-quality studies in a health-related area b. By the imaginations of creative he alth care workers, who design qualitative research that illuminates our understanding

c. By dissemination of important results at conferences d. By publications that detail the newest advances in health care ANS: A Best research evidence is produced by the conduct and synthesis of numerous high-quality studies in a health-related area.

DIF: Cognitive Level: Comprehension REF: MCS: 468

4. How are evidence-based practice and best research evidence related?

a. With best research evidence publications, there is no evidence-based practice. b. Both evidence-based practice and best research evidence are generated by research. c. Best research evidence is the evidence on which practice is based. d. Best research evidence includes five basic items, one of which is evidence -based practice.

ANS: C Evidence-base d pr actice is the conscientious integration of best rese arch evide nce with clinical expertise and patient value s and needs in the delivery of quality, cost-e ffective health care. Best research evidence is produced by the conduct and synthesis of a number of high-quality studies in a selected health-related area.

DIF: Cognitive Level: Analysis REF: MCS: 468

5. If a trigger is defined as a condition of actual or potential harm to the patient, the nurses, or the institution, the Iowa model becomes a reactive problem-prioritization and problem -solving pr ocess. What is its tie-in with evidence-based practice?

a. The Iowa model addresses utilization of research findings at an individual level. b. Individual nurse s enact an Iowa decision tree when they examine riskmanagement data.

c. Available published evidence drives the process, as scholars review the literature and bring it forward for committee focus.

d. When evidence is available, it is used for problem-solving.

ANS: D The Iowa Model of Evidence-Based Practice provides direction for the development of EB P in a clinical agency.

In a health care agency, triggers initiate the need for change, and the focus should always be to m ake change s based on best research e vidence. The se triggers can be problem -focused and evolve from risk management data, pr ocess improvement data, benchm arking data, financial data, and clinical problem s. The triggers can also be knowledge - focused: for example , new research findings, changes in national agencies or organizational

standards and guideline s, an expanded philoso phy of care, or que stions from the institutional standards committee. The triggers are evaluated and prioritized base d on the needs of the clinical agency. If a trigger is considered an agency priority, a group is formed to search for the best evidence to manage the clinical concern. In some situations, the research evidence is inadequate to m ake change s in practice, and additional studies are needed to strengthen the knowledge base. S ometimes the research evidence can be combined with other source s of knowledge (theories, scientific principle s, expert opinion, and case reports) to provide fairly strong evidence for developing research-based protocols for practice. The strongest evidence is generated from meta- analyses of several RCTs and system atic reviews that usually include meta-analyses, and individual studies. Thus, systematic reviews provide the best rese arch evide nce for developing evidence -based guidelines. The research-based prot ocols or evidence-based guideline s would be pilot-tested on a particul ar unit and then e valuated to determine the impact on patient care. If the outcome s are favor able from the pilot test, the change would be m ade in practice and monitored over time to determine its impact on the agency environment, staff, costs, and the patient and family. An agency can prom ote EBP by using t he Iowa model to identify triggers for change, im plement patient care base d on the best rese arch evidence, and monit or changes in practice to ensure quality care.

DIF: Cognitive Level: Synthesis REF: MCS: 493

6. In the Iowa model, what is the focus of intervention? a. The patient level b. The family level c. The institutional level d. The conceptual level ANS: C The Iowa Model of Evidence-Based Practice provides direction for the development of EB P in a clinical agency.

In a health care agency, triggers initiate the need for change, and the focus should always be to m ake change s based on best research e vidence. The se triggers can be problem -focused and evolve from risk management data, pr ocess improvement data, benchm arking data, financial data, and clinical problem s. The triggers can also be knowledge-

focused, such as new re search findings, change s in national agencie s or organizational standards and guidelines, an expanded philosophy of care, or que stions from the institutional standards committee. The triggers are evaluated and prioritized based on the needs of the clinical agency. If a trigger is considered an agency priority, a group is formed to search for the best evidence to manage the clinical concern.

DIF: Cognitive Level: Analysis REF: MCS: 493

7. A researcher locate s twelve research studies that all examine the effect of a different cognitive -behavior al strategy for decreasing painhypnosis, distraction, focusing, music therapy, and so forth. Why would these twelve studies make a poor meta-analysis?

a. Cognitive-behavioral interventions are not a suitable focus for all patients, and consequently should not be studied.

b. Twelve studies would be too many for synthesis of any kind. c. Secondary analyse s of pooled dat a are not used for meta-analysis on pain, because of interindividual differences in perception.

d. The result, if statistically significant, will produce a general recommendation, If in pain, do something cognitive-behavioral, which is meaningless.

ANS: D A meta-analysis is conducted to statistically pool the result s from previous studie s into a single quantitative analysis that provide s one of the highe st levels of e vidence about an interventions e ffectivene ss. This appr oach has objectivity, since it include s analysis techniques t o determine the effect of an intervention while examining the influence s of variations in the studie s selected for the meta-analysis. The studie s to be included in the analysis nee d to be examined for variations or heterogeneity in such areas as sample characteristics, sample size, design, type s of intervention, and outcomes variable s and measurement methods. Heterogeneity in the studies included in a meta-analysis produces broad and meaningless results.

DIF: Cognitive Level: Analysis REF: MCS: 482 MULTIPLE RESPONSE

1. The Magnet Program represents a credentialing process, whereby organizations of quality are recognized.

What doe s the Magnet Recognition Progr am require, relative to rese arch and evidence -based practice?

(Select all that apply.)

a. Nurses will participate in the institutional review process. b. Nursing research will be a budget line item. c. Only nurse researchers will conduct clinical research. d. The institution will keep track of nursing research projects in progress and recently completed.

e. Care applied to patients will be, in a large part, supported by research.

ANS: A, B, D Approval for Magnet st atus is obt ained thr ough the American Nur ses Credentialing Center (ANCC). The Magnet Recognition Program recognizes evidence-based practice as a way to impr ove the quality of patient care and revitalize the nursing environment. Selection criteria for Magnet status that require health care agencies to prom ote the conduct of research and the use of research evidence in practice follow. Some of its point items are availability of current literature, dissemination of current literature, application of current literature to practice, nurse involvement in the institutional review pr ocess, rese arch consultants actively involve d in mentorship, budget line items for nur sing research, tracking of all nursing research activities in progress, and education that has changed practice.

DIF: Cognitive Level: Analysis REF: MCS: 469

2. Evidence-base d practice is base d on three things. On what would a nurse base practice in a new area of nursing if there is yet no research evidence? (Select all that apply.)

a. Nursing theory b. The nurses own clinical expertise c. Client values and needs d. Evidence in parallel, related fields e. Past documentation in the medical record

ANS: B, C, D Evidence-base d pr actice is the conscientious integration of best rese arch evide nce with clinical expertise and patient value s and needs in the delivery of quality, cost-e ffective health care. Best research evidence is produced by the conduct and synthesis of a number of high-quality studies in a selected health-related area.

DIF: Cognitive Level: Analysis REF: MCS: 468

3. Which of the following statements about the Stetler model of research utilization are true? (Select all that apply.)

a. Its goal is to assure that research it utilized. b. It is a framework. c. It facilitates synthesis of research knowledge. d. It is used to update hospital policies. e. In its validation phase, scientific soundness is assessed. f. It provides a step-by-step way to assess and evaluate research findings.

ANS: B, C, D, E, F The Stetler (2001) model provides a com prehensive fr amework to enhance the use of research findings by nurses t o facilitate an evidence-based practice. The use of rese arch findings can be at the institutional or individual level. The five stages of the Stetler model are preparation, validation, comparative evaluation/decision m aking, translation/application, and evaluation. It is used to synthesize rese arch knowle dge, but it does this in a step-by-step way, evaluating e ach study on its own merits. Ultimately, it s use is practice-based.

DIF: Cognitive Level: Analysis REF: MCS: 493

4. What are the basic problems with meta-syntheses of qualitative research? (Select all thatapply.) a. Qualitative rese arch itself is a subjective interpretation; a meta-synthe sis of qualit ative research is a compiling of information generated subjectively.

b. If individual studies have different methods, it may be difficult to find common ground and to devise a meaningful interpretation of the results.

c. Qualitative rese arch has no implications for practice, so per forming a meta- synthe sis is unjustifiable.

d. In qualitative research, multiple valid interpretations m ay occur if different researchers examine the text.

e. The recommendation for practice that results from meta-synthe sis of qualitative research lacks statistics.

f. The raw data are not available to the qualitative meta-synthesizer.

ANS: A, B, D, F Meta-synthesis is defined as the systematic compiling and integration of qualitative stud y results to expand understanding and de velop a unique interpretation of study findings in a selected area. The focus is on interpretation rather than the com bining of study result s as with quantitative research synthe sis. Met asynthesis involve s the breaking down of findings from different studies to discover essential feature s, and then the combining of these ideas into a unique , transformed whole. Meta-summary is a step in conducting metasynthesis. A process for conducting a meta- synthesis is de scribed in the following section. The process of interpretation occurs in the mind of the reader. Corbin and Strauss describe interpretation as translating the words and actions of participants into meanings that reader s and consumers can underst and. The virtual text grows in size and complexity as the researcher reads and rereads the transcripts. Throughout the process of analysis, the virtual text develops and evolves. Although multiple valid interpretations m ay occur if different researchers examine the text, all findings must remain trustworthy t o the data. This trustworthiness applie s to the unspoken meanings emerging from the totality of the data, not just the written words of the text.

DIF: Cognitive Level: Synthesis REF: MCS: 490

5. Nursing practice has been said to have the potential to be increasingly evidence-based in the next ten years. What are the impediments to enacting EBP? (Select all that apply.)

a. A misunderstanding of what EBP is has resulted in mandate s and policies; bedside nurses sense that their expertise is being overridden.

b. Only about one-se venth of published nursing research is experimental or quasiexperimental.

c. Systematic reviews and meta-analyses in nursing are limited. d. Most hospitals do not have computer access to practice evidence. e. Population-based knowledge may or may not translate to the care of individual patients.

ANS: A, B, C, E Barriers to the EBP movement have been both pr actical and conceptual. One of the m ost serious barriers is the lack of re search evidence available regarding the effectiveness of m any nursing interventions. Between 2000 and 2006, published research in major journals was only 7% experimental and 6% quasi-experimental; interventional studies are required for EBP. The systematic reviews and meta-analyses conducted in nursing have been limited. Another concern of the EBP movement is that the development of evidence-base d guidelines has led to a cookbook approach to health care. He alth profe ssionals are expected to follow these guidelines in their practice as developed. However, the definition of EBP de scribes it as the conscientious integration of best research evidence with clinical expertise and patient values and needs.

DIF: Cognitive Level: Evaluation REF: MCS: 471

6. A systematic review should address the components specified in PICOS . Why is this so? (Select all that apply.)

a. Interventional research always uses some means of comparison. b. Interventions that are actually naturally occurring conditions should be noted, since they decrease confirmatory power of the collective evidence.

c. Study design is essential, since recommendations for change in pr actice can be based only on some designs.

d. Desired outcomes, not actual outcomes of the study, are the focus of the review. e. The specific population from which a sample was drawn, and its similarity to those of others studies reviewed, affects generalizability.

ANS: A, B, C, E

A systematic review is a structured, comprehensive synthe sis of the research literature to determine the best research evidence available to address a health care question. A systematic review involve s identifying, locating, appraising, and synthe sizing quality rese arch evidence for expert clinicians to use to promote an EBP. Systematic reviews are often conducted by two or more researchers and/or clinicians in a selected area of interest to determine the best research knowledge in that area. Systematic reviews need to be conducted with rigorous research methodology to promote the accuracy of the findings and minimize the reviewers bias. A systemic review or meta-analysis is best directed by a relevant clinical question that focuses the review pr ocess and prom otes the development of a quality synthesis of research evidence. One of the most common format s used to organize a systematic review is the PICO or PICOS form at describe d in the Cochran Handbook. PICOS are (1) population (or sam ple), (2) intervention, (3) com parison group or condition, (4) outcomes, and (5) study design. Naturally occurring interventions indicate a non-interventional design; the researcher enacts the research intervention.

Chapter 20. Collecting and Managing Data MULTIPLE CHOICE

1. Planning as a step in the quantitative research proce ss ends when the data collection has begun.

Which is the true statement about planning in the qualitative research process?

a. Since sample size is not usually decided upon ahead of time, there is no practical reward to planning the qualitative research study ahead of time.

b. There is no planning in the qualit ative research process; it all emanates from the dat a collected.

c. Everything about a qualitative study is planned ahead of time, except for analysis of the data. d. The researcher may adapt strategies for data collection or analysis well into thestudy.

ANS: D

A data collection plan details how the researcher will implement the study. The plan for collecting data is specific to the study being conducted and requires that the researcher consider some of the more common elements of rese arch, m apping out procedures ahe ad of time. This extensive planning i ncrease s the accur acy of the data collected and the validity of the study findings. In qualit ative methods, howe ver, the researcher may adapt the data collection or analysis strategies during the study.

DIF: Cognitive Level: Analysis REF: MCS: 517

2. What is the general rule about collecting demographic data during an interview? a. The mood of the qualitative interview, so crucial t o quality data capture, may be intruded upon by demographic data collection.

b. In quantitative interviews, e verything excerpted from medical records must again be verified in face interviews.

c. In qualitative interviews, routinely asking twenty or thirty demographic que stions sets the stage for actual data collection.

d. If data can be obtained in other ways, leave the valuable interview time for actual interviewing.

ANS: D The researcher should consider the importance of each piece of datum and the subjects time required to collect it. If the data can be obtained fr om patient records or any other written sources, the researcher doe s not need to ask the subject to provide this inform ation. T o collect data from a patients recor ds, the researcher must make sure to include the intent t o do so in the consent form and ensure that the institutional review board has authorized the team to do this. The qualitative researcher has the power to shape the interview agenda. Participants have the power t o choose the le vel of responses they will provide. The rese archer might begin the interview by asking a broad question such as De scribe for me your experience with or Tell me about .

Ideally, the participant will respond as though she or he is telling a story. The researcher responds nonverbally with a nod or eye contact to convey interest in what is being said, and tries to avoid agreeing or disagreeing with what the participant is saying. The less the researcher says, the better.

DIF: Cognitive Level: Comprehension REF: MCS: 517

3. A researcher is collecting data in a hospital during cardiopulmonary resuscitation. The researcher has devised a data collection form that contains five columns for data entry. During the first three data collection periods, the form works reasonably well, although the researcher has to turn the MCS: over and write on the back. During the fourth, however, the CPR incident occurs in the emergency department and includes many procedures and interventions, and the researcher ends up taking a blank piece of paper and recording data on that. Later, it takes him 40 minutes to unscramble and collate the data and record it properly. What must be done now?

a. The researcher will go back t o the institutional review board and reque st permission to use a different form.

b. The researcher will design a new form, with the assum ption that the next CPR incident will be just as complex as the last was.

c. The researcher will continue t o use the old form, writing on the back when necessary, and pulling out blank pieces of paper, from time to time, for additional data recording.

d. The researcher will decrease the amount of data necessary to record by revising the old study protocol, so that fewer research questions are asked.

ANS: B Before data collection begins, the researcher develops or adapts forms on which to record data. The se forms can be used to record demogr aphic dat a, inform ation from the patient record, observations, or values from physiological measures. The researcher also might need to collect other data that may be extraneous or confounding variable s such as the subjects physician, stage of illness, length of illne ss or hospitalization, complications, date of data collection, time of day and day of wee k of data collection, and any untoward events that occur during the data collection period. Dat a collection form s must be designed so that the data are easily recorded. If a form isnt working, de sign a better form. Data collection forms themselves do not need institutional review board (IRB) approvalthe information to be collected is what the IRB approves.

DIF: Cognitive Level: Application REF: MCS: 517

4. The quantitative researcher collects many pieces of quantitative data as words, not numbers. Prior to statistical analysis, all of the data pieces must be coded. What does this mean?

a. The data are transformed int o numerals corresponding to words, such as 0no college degree, 1bachelors degree, 2masters degree, 3PhD or EdD.

b. The essence of each word is noted; later, these essences emerge as themes. c. The data are typed into a computer, and the computer is instructed to transform the words into binary value s, using only 0 and 1, by adding up the number s of each letter in the alphabet.

d. The data regarding protected data are transformed to code names; a list is m ade and kept in a secure location.

ANS: A Coding is the process of transforming language data into numerical sym bols that can be entered easily into the computer. For example, variables such as race , gender, ethnicity, and diagnoses can be categorized and given numerical labels. For gender, the male category could be identified by a 1 and the female category by a 2.

The coding categories developed for the rese arch must be both mutually exclusive and mutually exhaustive so, with respect to the latter, inclusion of 3decline to state and 4none of the above might be useful.

DIF: Cognitive Level: Application REF: MCS: 517

5. A nurse is conducting her masters the sis research in the unit in which she works as a st aff nurse . The focus of her the sis is burne d childrens pain, with versus without a child life specialist assisting the child. She is providing child life specialist presence every other day at the mid - morning dressing change. For obvious reasons, she wants to keep everything else consistent for the four contiguous days of data collection. On the second day of four, with the child life specialist present, one child demonstrate s poor pain control. The nurse researcher would ordinarily advocate for more pain medication for this child, but if she does, she will not be able to compare the data with that of the previous day. This is an example of which of the following?

a. Serendipity b. Subject as object c. Role conflict d. Passive ANS: C

resistance

As a researcher, one is observing and recording event s. Nur ses who conduct clinical rese arch often experience a conflict between their researcher role and their clinician role during dat a collection. In some case s, the researchers involvement in the event, such as providing physical or emotional care to a patient during data collection, could alter the event and thus bias the results. It would be difficult to generalize the findings to other situations in which the re searcher was not pre sent to intervene. However, the nee ds of patient s must take precedence over the needs of the study.

DIF: Cognitive Level: Application REF: MCS: 528 MULTIPLE RESPONSE

1. A researcher intends t o collect dat a, including patients ratings of pain and anxiety, during a procedure. No electrical equipment or photography may be used in the procedure room. In order to record the various pain and anxiety ratings, the researcher may plan to use which of the following? (Select all that apply.)

a. A plug-in word processor b. A form with large margins, or a column for comments, or both c. A pencil with an eraser d. A form with pre-labeled columns and rows e. A cell phone with camera ANS: B, C, D Before data collection begins, the researcher develops or adapts forms on whic h to record data. The se forms can be used to record demogr aphic dat a, inform ation from the patient record, observations, or values from physiological measures. The researcher also might need to collect other data that may be extraneous or confounding variable s such as the subjects physician, stage of illness, length of illne ss or hospitalization, complications, date of data collection, time of day and day of wee k of data collection, and any untoward events that occur during the data collection period. Dat a collection form s must be designe d so that the data are easily recorded. Pencil and paper are ideal, since they allow for erasure, in case the subject clarifies data.

DIF: Cognitive Level: Application REF: MCS: 517

2. Part of a research study entails that rese arch subjects complete a printed form with checkboxe s. The researcher decides ahe ad of time that any item that has more than one response checked will be treated as unanswered. What are logical ways the researcher can maximize properly answered items, without skewing the data? (Select all that apply.)

a. Make a rule that if there are two checked replies, only the first one will becounted. b. When the researcher hands the form to the subjects, the researcher should specify One answer and one answer only for each these items, ple ase , or I wont be able t o include the double-answered ones in my report.

c. Glance at the forms as they are about to be handed in, and if two boxes for an item are checked, ask the subject to address this.

d. In the printed instructions at the top of the form, be sure to st ate that if a que stion has m ore than one response checked, that item will be treated as unanswered.

e. Eliminate from the entire study any subject who double-selects an item.

ANS: B, C, D Decision rules for data entry should be finalized during the planning proce ss. T he researcher must realize that any decision rule m ay skew the data. For example, if a subject select s two responses for a single item, will the variable be coded as missing, or doe s the researcher want to specify that the lowest or highe st value should be entered?

DIF: Cognitive Level: Application REF: MCS: 523

3. A researcher is studying the way that ICU nur ses prioritize the charting responsibilities for their 12-hour shift. The researcher happens t o discover that nur ses are administering medications as close t o the ordered times as possible but consistently charting the times at which medications are ordered, not the time they are actually administered, even though that may be two or three hours later. What could the researcher do with this information? (Select all that apply.)

a. The researcher makes the nurse m anager aware of the finding, after the study data have all been collected, because this is essentially a medication charting error.

b. Nothing. This is not a focus of the study, and the information must be suppressed.

c. The researcher takes time to educate individual nurse s, so that they underst and that what they are doing is not honest.

d. The researcher includes the findings in the article, stating that this is a time- saving strategy, since the computer allows charting of meds when ordered (instead of when administered) as a block, saving time.

e. The researcher reports this information under Serendipitous Discoveries in the article that results from the study.

ANS: A, B, E Serendipity is the accidental discovery of something useful or valuable. During the data collection phase of studies, researchers often become aware of elements or relationships that they had not previously identified.

These aspects m ay be closely related to the study being conducted or have little connection with it. They come from increased awarene ss and close observation of the study situation. Because the researcher is focused on close observation, other elements in the situation can come into cle arer focus and t ake on new me aning.

Serendipitous findings are important to the development of new insights in nur sing theory. They can be important for understanding the totality of the phenomenon being examined.

Educating individual nur ses is sure to alienate staff. The manager is the logical choice for a person in whom to confide this information. Obviously, this should be communicated as, Some nurse s rather than naming names, since the nurses privacy would be violated by telling their names.

DIF: Cognitive Level: Application REF: MCS: 530

4. How may research data, code-named and stripped of all identifiers, be stored? (Select all thatapply.) a. Separate from the master list of identifiers and codes b. Only in a locked box in a safe c. Anywhere the researcher decides to store it that has reasonable security d. Only in the original database from which it was derived e. Only in a password-protected computer, located in a private office or residence

ANS: A, D In this time of flash drives and thumb drives, it is relatively easy to store data. The original data forms and database must be stored for time frame s dictated by the funding source or by the journal publisher. There are several reasons to store data. The data can be used for secondary analyse s. For example, researchers participating in a project related to a particular research focus m ay pool dat a from various studies for acce ss by all members of the group. Data should be available t o document the validity of your analyses and the published results of your study.

Because of nationally publicized incidents of scientific misconduct in which rese archers fabricated data and published multiple manuscripts, you would be wise to preserve documentation that your dat a were obtained as you claim. Issues that have been raised include how long data should be st ored, the need for institutional policy regar ding data storage, and whether graduate student s who conduct a study should leave a copy of their data at the university. Some rese archers st ore their data for only five ye ars after publication, while others store their data until they retire from a research career. Researcher s should check with their funding sponsors and publishers for guidelines on how long to keep the data. Most researchers store data in their office or laboratory; others archive their data in a central location with storage fees or retrieval fees. HIPAA mandates protection of anonymity by removing all 18 identifiers for data; a master list of the code-labeled data and the person to whom it belonged must be ke pt separate from the main data. The m aster list must be kept in a locked area.

DIF: Cognitive Level: Analysis REF: MCS: 532

5. How may raw research data, with identifiers, obtained from a hospital be stored? (Select all that apply.) a. It must be kept only in the hospit als com puter system; at the end of the work day, all excerpted data must be deleted.

b. In a locked box in a safe c. In any e-mail account d. On a private website e. In a password-protected computer, located in a private office or residence ANS: B, E

In this time of flash drives and thumb drives, it is relatively easy to store data. The original data form s and database must be stored for time fr ames dictated by the funding source or by the journal publisher. There are several reasons to store data. The dat a can be used for secondary analyses. For example, researchers participating in a pr oject related to a particular research focus may pool data from various studie s for access by all members of the group. Dat a should be available to document the validity of your analyses and the published results of your study.

Because of nationally publicized incidents of scientific misconduct in which rese archers fabricated data and published multiple manuscripts, you would be wise to preserve documentation that your dat a were obtained as you claim. Issues that have been raised include how long data should be st ored, the need for institutional policy regar ding data storage, and whether graduate student s who conduct a study should leave a copy of their data at the university. Some rese archers st ore their data for only five ye ars after publication, while others store their data until they retire from a research career. Rese archers should check with their funding sponsors and publishers for guidelines on how long to keep the data. Most researchers store data in their office or laboratory; others archive their data in a central location with storage fees or retrieval fees. HIPAA mandates protection of anonymity by removing all 18 identifiers for data; a master list of the code-labeled data and the person to whom it belonged must be ke pt se parate from the main data. The m aster list must be kept in a locked area.

DIF: Cognitive Level: Analysis REF: MCS: 532

6. What are the purposes of completing a pilot study? (Select all that apply.) a. It provides nominal and ordinal data with which the researcher can construct better instruments.

b. It helps identify problems the researcher might encounter while collecting data. c. It justifies the existence of a research gap. d. It gives the researcher preliminary data t o present to the institutional review board in order to obtain permission to conduct research.

e. It provides an ide a of the timelines of the proposed study, including instrument completion and subject recruitment.

ANS: B, E

Completing a pilot study m ay save the researcher difficulty later when the final steps of the research proce ss are implemented. Pilot testing helps to identify problem s that might be encountered while collecting data, and helps develop strategie s for addressing potenti al problem s. Following approval of the study by your institutional review board (IRB), the studys approved research plan is used to recruit 3 to 5 pilot subjects who meet the eligibility criteria. The same study data collection methods are utilized, paying special attention to how long it takes to recruit a subject, obt ain informed consent, and collect the data. Often, the participant is asked t o identify questions or aspects of the process that were unclear or confusing. Based on the pilot study and feedback of the first subjects, data collection forms and methods of dat a collection may be modified to improve feasibility, validity, and reliability.

DIF: Cognitive Level: Analysis REF: MCS: 532

7. What are the four principal tasks of data collection? (Select the four that apply.) a. Performing constant comparison for qualitative data b. Maintaining research controls as indicated in the study design c. Solving problems that threaten to disrupt the study d. Cross-checking with the literature review e. Collecting data in a consistent way f. Staying with institutional review board permission g. Selecting subjects ANS: B, C, E, G In both quantitative and qualitative rese arch, the investigator performs four tasks during the process of data collection. These tasks are interrelated and occur concurrently rather than in se quence. The tasks are: (1) selecting subjects, (2) collecting data in a consistent way, (3) maint aining research controls as indicated in the study design, and (4) solving problems thatthreaten to disrupt the study.

Chapter 21. Introduction to Statistical Analysis Test Bank

MULTIPLE CHOICE

1. A researcher who has conducted experimental research finds that in his 145-per son hospital study the patients who are ambulated on the e vening of abdominal surgery are less likely than the control group to develop postoperative pneumonia. What does the researcher infer?

a. The control group resembled the experimental group in all import ant characteristics.

b. Early ambulation and pneumonia are strongly related. c. Evening-of-surgery ambulation will prevent some case s of postoper ative pneumonia in abdominal surgery patients.

d. Careful support of the abdomen is important for postoper ative ambulation in patients who have had abdominal surgery.

ANS: C Statisticians use the term inference or infer in somewhat the same way that a researcher use s the term generalize. Inference requires the use of inductive reasoning. One infers from a specific case to a general truth, from a part to the whole, from the concrete to the abstract , from the known to the unknown. When using inferential reasoning, one can never prove things; one can never be certain. Howe ver, the rules that have been established with regard to statistical procedures so as to increase the probability that inference s are accurate.

Inferences are m ade cautiously and with great care. Rese archers use inferences to infer from the sam ple in their study to the larger population.

DIF: Cognitive Level: Analysis REF: MCS: 537

2. What is this particular distribution called? a. Bimodal b. Normal c. Camelesque d. Negatively ANS: A

skewe d

Another characteristic of distributions is their modality. Most curves found in pr actice are unimodal, which means that they have one mode and frequencies progressively decline as they move away from the mode.

Symmetrical distributions are usually unimodal. However, curve s can also be bim odal or multimodal. accurately reflect the shape of the population from which the sample was taken.

DIF: Cognitive Level: Application REF: MCS: 540

3. A researcher reports that the heights of men aged 53 living in Rapid City, South Dakota, are between 57 and 60 and that the confidence interval is calculated at the p <.05 level. What does this mean?

a. If the heights of men in Rapid City, South Dakota, do not fall within the confidence interval at least 5% of the time, a type I error has occurred.

b. If a 53-year-old man in Rapid City, South Dakota, is measured, there is a 95% chance that his height will fall in the 57 through 60 interval.

c. Ninety-five percent of the 53-year -old men living in Rapid City, South Dakota, are between 57 and 60.

d. The heights of the men in the sample were all between 57 and 60, and t he sample was representative of 95% of the men in town.

ANS: B When the probability of including the value of the parameter within the interval estimat e is known, this is referred to as a confidence interval. Calculating a confidence interval involve s the use of two formulas to identify the upper and lower ends of the interval. A confidence interval is actually an estimate.

DIF: Cognitive Level: Synthesis REF: MCS: 541

4. There are four data set s: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9

C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the mean of the four individual data sets? a. 5, 5, 5, 5 b. 1, 4, 5, 5 c. 1, 2, 5, 5 d. 5 ANS: A The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the me an, median, and m ode. All of the se st atistics are representations or de scriptions of the center or middle of a frequency distribution. The mean is the arithmetic aver age of all of a variables value s.

The median is the exact middle value (or the average of the middle two value s if there is an even number of observations). The mode is the m ost commonly occurring value in a dat a set. In a normal cur ve, the me an, median, and mode will be equal or approximately equal DIF: Cognitive Level: Analysis REF: MCS: 538

5. There are four data sets: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9 C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the median of the four individual dat a set s? a. 5, 5, 5, 5

b. 1, 4, 5, 5 c. 1, 2, 5, 5 d. 5 ANS: B The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the me an, median, and m ode. All of the se st atistics are representations or de scriptions of the center or middle of a frequency distribution. The mean is the arithmetic aver age of all of a variables value s.

The median is the exact middle value (or the average of the middle two value s if there is an even number of observations). The mode is the m ost commonly occurring value in a dat a set. In a normal cur ve, the me an, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538

6. There are four data sets: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9 C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the mode of the four individual data set s? a. 5, 5, 5, 5 b. 1, 4, 5, 5

c. 1, 2, 5, none d. 1 ANS: C

The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the me an, median, and m ode. All of the se st atistics are representations or de scriptions of the center or middle of a frequency distribution. The mean is the arithmetic aver age of all of a variables value s.

The median is the exact middle value (or the average of the middle two value s if there is an even number of observations). The mode is the m ost commonly occurring value in a dat a set. In a normal cur ve, the me an, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538

7. Which of the following is the best example of a normally distributed data set? a. 1, 1, 1, 1, 1, 10, 10, 10, 10 b. 2, 2, 2, 2, 4, 8, 8, 8, 9 c. 3, 4, 4, 5, 5, 5, 6, 6, 7 d. 1, 2, 3, 4, 5, 6, 7, 8, 9 ANS: C The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the me an, median, and m ode. All of the se st atistics are representations or de scriptions of the center or middle of a frequency distribution. The mean is the arithmetic aver age of all of a variables value s.

The median is the exact middle value (or the average of the middle two value s if there is an even number of observations). The mode is the m ost commonly occurring value in a dat a set. In a normal cur ve, the me an, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538

8. One hundred student s took an exam; the mean of the test was 45%, and the median was 38%; seventy students scored below the mean, but three scored more than 96% . This would represent what type of distribution?

a. Normal

b. Positively skewed c. Negatively skewed d. Leptokurtic ANS: B Any curve that is not symmetrical is referred to as skewed or asymmetrical. Skewness may be exhibited in the curve in a variety of ways. A curve may be positively skewed, which means that the largest portion of dat a is below the me an. A curve can also be negatively skewed, which me ans that the largest portion of dat a is above the mean. A normal curve is symmetric and has no skew. Few sample s will be perfectly symmetrical; however, as the deviation from symmetry increases, the seriousness of the impact on statistical analysis incre ase s. In a positively skewed distribution, the mean is greater than the median, which is greater than the mode . In a negatively skewed distribution, the mean is less than the median, which is less than the mode.

DIF: Cognitive Level: Analysis REF: MCS: 540

9. In the following illustration of a negatively skewed curve, which line represents the mode? a. First dotted line b. Second dotted line c. Third dotted line ANS: C In a skewed distribution, the me an, me dian, and mode are not equal. In a negatively skewed distribution, the mean will be less than the median, which will be less than the mode.

DIF: Cognitive Level: Application REF: MCS: 540

10. Which of the following distribution curves demonstrates the least amount of variation in thescores? a. The least amount of variation would be in the first curve. b. The least amount of variation would be in the second curve.

c. The least amount of variation would be in the third curve. d. The amount of variation cant be defined by the curve.

ANS: A Kurtosis explains the degree of pe akedness of the distribution curve , which is related to the spread of the variance of scores. An extremely peaked curve is referred to as lept okurtic, an intermediate degree of kurtosis as mesokurtic, and a relatively flat curve as platykurtic. The le ss peaked the curve, the more variation is present.

DIF: Cognitive Level: Application REF: MCS: 541

11. is the symbol for which of the following? a. Sample mean b. Population mean c. Population variance d. Sample variance ANS: A Use of the terms statistic and parameter can be confusing because of the various populations referred to in statistical theory. A statistic (such as a me an, ) is a numerical value obtained from a sample. A parameter is a true (but unknown) numerical characteristic of a population. For example, is the population mean or arithmetic average. The mean of the sampling distribution (mean of sam ples means) can also be shown to be equal t o .

Thus, a numerical value that is the mean () of the sample is a statistic; a numerical value that is the mean of the population () is a parameter.

DIF: Cognitive Level: Comprehension REF: MCS: 537

12. A researcher conducts a statistical test that reveals that the four groups analyzed differed. The researcher wants to discover which one or ones of the four differed from the other s. The rese archer must then perform a post hoc analysis. What will this involve?

a. Design of a second research study, using a new sample b. Descriptive statistics about the sample demographics c. Qualitative research generating new themes and ideas d. A second statistical test using the original data ANS: D Post hoc analyses are comm only performed in studies with more than two groups when the analysis indicates that the groups are significantly different but does not indicate which groups are different. A post hoc analysis must be performed to determine which of the three groups are significantly different. In other studies, the insight s obt ained through the planned analyses generate further questions that can be examined with the available data.

DIF: Cognitive Level: Application REF: MCS: 545

13. Where would one find appr oximately 95% of the scores in the following example if scores are normally distributed?

Scores ranged from 30 to 68, M = 45, SD = 7.

a. Between 37 and 61 b. Between 38 and 52 c. Between 31 and 59 d. Between 30 and 68 ANS: C The range, standard deviation, and variance are statistics that describe the extent to which the values in the sample vary from one another. The most common of these st atistics to be reported in the literature is the standard deviation, because of its direct association with the normal cur ve. If the frequency distribution of any given variable is approximately norm al, knowing the st andard deviation of that variable allows us to know what percentages of subjects values on that variable fall between +1 and 1 standar d deviation. Referring back to the hypothetical freque ncy distribution of pain in Figure 21-1, when we calculate a standard deviation, we know that

34.13% of the subjects pain scores were between the mean pain score and 1 standard deviation above the mean pain score. We also know that 34.13% of the subject s pain scores were between the mean pain score and 1 standard de viation below the mean. The middle 95.44% of the subjects scores were between 2 standard deviation and +2 standard deviations.

DIF: Cognitive Level: Evaluation REF: MCS: 541

14. If a researcher wishes to predict with 97.5% accuracy, the level of significance would bea. .05 b. .01 c. .25 d. .025 ANS: D If one wishe s to predict with 95% accuracy, the level of significance (p) is 1 minus 95% = .05. In nursing research, alpha is usually set at 0.05, meaning that the researcher will allow a 5% or lower chance of making a type I error.

DIF: Cognitive Level: Application REF: MCS: 535 MULTIPLE RESPONSE

1. A researcher states in an article that a new experimental treatment, trialed in the outpatient setting in a tri-physician practice in northern Oregon, produce s better outcomes than the control treatment for patients with COPD. Thep-value given is p <.05. What does this mean? (Select all that apply.)

a. There is better than a 95% chance that at the research site mentioned in the article the experimental treatment really DOES produce better outcomes for patients with COPD.

b. The probability of error is 95%. c. There is very little chance that the intervention is effectiveless than a 5% chance, in fact.

d. There is better than a 95% chance that the experimental treatment will produce better outcomes for all COPD patients.

e. There is less than a 5% chance that the researcher has reached this conclusion inerror.

ANS: A, D, E Probability theory addresse s statistical analysis as the likelihood of accurately predicting an e vent or the extent of an effect. In pr obability theory, the meaning of statistical result s is interpreted by the re searcher in light of his or her knowledge of the field of study. Probability is expre ssed as a lowercase p, with values expressed as percentages or as a decimal value ranging from 0 to 1.

DIF: Cognitive Level: Synthesis REF: MCS: 535

2. A null hypothesis is st ated. The null hypothesis is, There is no difference between 10 mcg and 20 mcg of vitamin D 3 in prevention of osteopor osis. What are the implications of this st atement, concerning that hypothesis and type I error? (Select all that apply.)

a. Rejecting the null hypothesis when it actually is false means that the researcher has made a type I error in concluding that there is a difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis.

b. Making the statement is itself a type I error. c. Whether the null hypothesis is true or not makes no difference in terms of type I error. d. Whether or not the researcher rejects the null hypothesis m ake s no difference in terms of type I error.

e. Rejecting the null hypothe sis whe n it actually is false means that the researcher concludes that there is a difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, and there is no error.

f. Rejecting the null hypothesis when it actually is true means that the re sear cher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D 3 in preventing osteoporosis, but the researcher thinks there is and has made a typeI error.

ANS: E, F

Type I error is the probability of rejecting the null hypothesis when it is in fact true. It is also calle d alpha []. In nursing studie s, this is usually .05, which equals 5%. To test the null hypothe sis, the re searcher consult s a statistics website or book, to discover the decision point or cutoff point, which is the value at which rejecting the null hypothesis would be the wrong decision only 5% of the time. Then the researcher calculates the statistic, based on the dat a. If the value of the statistic is le ss than the cutoff point, the null hypothesis st andsit is not rejected. If the value of the st atistic is m ore than the cutoff point, the null hypothe sis is rejected. This will be the correct decision 95% of the time.

DIF: Cognitive Level: Analysis REF: MCS: 535

3. A null hypothesis is st ated. The null hypothesis is, There is no difference between one baby aspirin every day and no baby aspirin at all in prevention of myocardial infarction. What are the implications of this statement, concerning that hypothesis and type II error? (Select all that apply.)

a. Accepting the null hypothesis when it actually is true means that the researcher has made a type II error in concluding that there is no difference between 10 mcg and 20 mcg of vit amin D3 in preventing osteoporosis.

b. Making the statement is itself a type II error. c. Whether the null hypothesis is true or not makes no difference in terms of type II error. d. Whether or not the researcher rejects the null hypothesis makes no difference in terms of type II error.

e. Accepting the null hypothesis when it actually is true means that the re searcher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D 3 in preventing osteoporosis, and there is no error.

f. Accepting the null hypothe sis when it actually is false means that the researcher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, when there actually IS a difference. The researcher has therefore made a type II error.

ANS: E, F Type II error is the probability of retaining the null hypothesis whe n it is in fact false. In nursing research, type II error is usually set at .20. This means that a type II error, failure to detect a

difference when it indeed exists, will occur 20% of the time. One minus beta [] equals the power of the study.

This is the research studys power to detect a difference when it indeed does exist.

DIF: Cognitive Level: Analysis REF: MCS: 535

4. As researcher designs a study to measure the effect on patient satisfaction of the nurse stating to the patient at le ast once a day, Youre a good person. The re searcher set s the alpha (type I error) for the study at p <.10 because the intervention is free, it needs next to no time to enact, and it is harmless. I f the alpha is set at .10, what is the effect on the beta [] and on type II error? (Select all that apply.)

a. Beta [] stays the same. b. Type II error becomes less likely. c. Type II error becomes more likely. d. Beta [] decreases. e. Beta [] increases as well. f. Type II error stays the same.

ANS: B, D The researcher chooses the probability of making a type I error when setting alpha [], and if the researcher sets the probability of making a type I error quite low, perhaps only 1%, the probability of making a type II error, [], increases. By the same token, if the researcher sets the probability of making a Type I error quite high, perhaps 10%, the probability of making a type II error decreases.

DIF: Cognitive Level: Analysis REF: MCS: 536

5. In statistical hypothesis testing, which of the following occur be fore the dat a are collected? (Select all that apply.)

a. The beta (type II error) is set. b. A power analysis is conducted. c. The null hypothesis is accepted or rejected.

d. The alpha (type I error) is set. e. The primary null hypothesis is stated.

ANS: A, B, D, E The following steps outline each of the components of st atistical hypothe sis testing. The null hypothesis is stated. T he study alpha (type I error) is set. The study beta (type II error) is set. A power analysis is performed.

The study is conducted. The statistic is com puted, based on the dat a obtained. The obtained statistic is compared with the critical value for the alpha chosen. If the obt ained statistic is greater than the critical value, the null hypothesis is rejected; if the obt ained statistic is less than the critical value, the null hypothe sis is accepted.

DIF: Cognitive Level: Analysis REF: MCS: 535

6. If beta, , is the probability of making a type II error, what is 1 minus ? (Select all that apply.) a. Alpha [] b. A relationship exists c. The power of the study d. The likelihood that the null hypothesis is incorrect e. The probability of not making a type II error ANS: C, E Power is the probability that a statistical test will detect an effect when it actually exists. Therefore, power is the inverse of type II error and is calculated as 1 . Recall that type II error is the probability of retaining the null hypothe sis whe n it is in fact false . When the researcher sets type II error at 0.20 prior to conducting a study, this means that the power of the planne d statistic has been set to 0.80. In other words, the statistic will have an 80% chance of detecting an effect if it actually exists.

DIF: Cognitive Level: Analysis REF: MCS: 536

7. A researcher is concerned about the power of his study. His planned interventional study examines the effect upon depression of instituting twice-yearly trips with a Road Scholar

program for widows and widowers who have, 1 to 2 years before, lost a spouse to a long illness. What strategies could make type II error less likely? (Select all that apply.)

a. Decreasing the effect size b. Increasing the alpha from .05 to .10 c. Increasing the beta from .20 to .30 d. Decreasing the beta from .20 to .10 e. Decreasing the alpha from .05 to .025 f. Increasing the sample size ANS: B, D, F Power is the probability that a st atistical test will detect an effect when it actually exists. Therefore, power is the inverse of type II error and is calculated as 1 . Recall that type II error is the probability of retaining the null hypothe sis whe n it is in fact false. When the researcher sets type II error at 0.20 prior to conducting a study, this means that the power of the planned statistic has been set to 0.80. In other words, the statistic will have an 80% chance of detecting an effect if it actually exists. Often, reported studies failing to reject the null hypothe sis (in which power is unlikely to have been examined) will have a low power level to detect an effect if one exists.

Until recently, the researchers primary interest was in preventing a Type I error. Therefore, great emphasis was placed on the selection of a level of significance but little on power. This point of view is changing. Power analysis involves determining the required sam ple size needed to conduct the study. Cohen identified four parameters of power: (1) significance level, (2) sample size , (3) effect size, and (4) power. If three of the four are known, the fourth can be calculated by using power analysis formulas. Effect size is a constant; it is the degree to which the phenomenon is present in the population or the degree to which the null hypothe sis is false.

Consequently, if the researcher wants to increase a studys power, the sample size must be increased, or the level of significance must be set at a less stringent level.

DIF: Cognitive Level: Analysis REF: MCS: 536

8. Findings can be st atistically significant be clinically not significant. Which of the following studies with statistically significant findings exemplify this? (Select all that apply.)

a. Seventy-five seconds of UV light daily can completely reverse the symptoms of allergic dermatitis.

b. Eating a cup of salad greens daily increases ones life expectancy by 2 years. c. Petting a cat for five minutes daily increases ones endorphin levels. d. Exercise Program Delta causes weight loss of 6.3 pounds per year in morbidly obese women.

e. Talking to a crying baby calms the baby more than ignoring it; picking up the baby calms it more than talking to it.

f. Medication R15B, taken daily from age 13, completely controls cystic acne byage 23.

ANS: C, D, E, F The findings of a study can be statistically significant but may not be clinically important. For example, one group of patients might have a body temper ature 0.1 F higher than that of another group. Data analysis might indicate that the two groups are statistically significantly different. However, the findings have little or no clinical importance due to the small difference in temperatures between groups. Persons with dermatitis would find the UV light treatment almost miraculous. Two extra years of life may be clinically important to those with good quality of life . Increasing endorphins is not due only to petting cat s, so this study is not particularly significant , clinically. A weight loss of 6.3 pounds per year is not large enough to make a significant difference in the life of a morbidly obese woman. Picking up crying babie s is something that even ones grandmother knows; this is not clinically useful. A me dication t hat controls cystic acne ten years later is of little use to the adolescent who is miserable with acne.

DIF: Cognitive Level: Analysis REF: MCS: 537

9. A measured value is within two standard deviations of the me an but not within one st andard de viation, and it is gre ater than the mean. The distribution is very close to a normal distribution. What doe s this signify?

(Select all that apply.)

a. This particular value is not an outlier. b. In the data set, almost 2/3 of the values are closer to the mean than this one is. c. The data point falls within the majority of the measured value s, in terms of its closene ss to the mean.

d. In the data set, at le ast 4% of the value s are further from the mean than this particular value is.

e. In this data set, between 65% and 95% of the values are smaller in value than this one is.

ANS: A, B, D, E The range, st andard deviation, and variance are statistics that de scribe the extent to which the values in the sample vary from one another. The most common of these st atistics to be reported in the literature is the standard deviation, because of its direct association with the normal cur ve. If the frequency distribution of any given variable is approximately normal, knowing t he standar d deviation of that variable allows the reader to know what percentages of subjects value s on that variable fall between +1 and 1 st andard de viation. In a normal distribution, when a standard deviation is calculated, 34.13% of the value s are between the me an score and 1 standard deviation above the mean. Similarly, 34.1 3% of the values are between the mean score and 1 standard de viation below the me an. The middle 95.44% of the subject s scores are be tween +2 st andard deviations and 2 standard deviations.

DIF: Cognitive Level: Synthesis REF: MCS: 541

10. Which of the following are true about a type II error? (Select all that apply.) a. It is more likely to occur when p <.01 rather than when p <.05. b. It is extremely likely to occur when p <.001. c. It occurs when the null hypothesis is true but rejected. d. It is a possibility only when there are statistically nonsignificant results in a study. e. It is a possibility only when there are statistically significant results in a study.

Chapter 22.

Test

Bank

MULTIPLE

CHOICE

1. The following is the frequency distribution for a set of data. What is the sets mode?

X

f

5

1

4

0

3

2

2

3

1

1

a. 5 b. 4 c. 3 d. 1 ANS: C The measures of central tendency are mode, median (MD), and mean (). The mode is the numerical value or score that occur s with the greatest frequency in a dat a set. It doe s not necessarily indicate the center of the data set.

DIF: Cognitive Level: Analysis REF: MCS: 555

2. In the data set below, what is the mean ()?

X

f

5

4

4

2

3

1

2

1

1

2

a. 4 b. 3.5 c. 3 d. 2.5

ANS: B The measures of central tendency are mode, median (MD), and mean (). The mean is the arithmetic average of all a variables value s in a study and is the most commonly reported measure of central tendency. The mean is the sum of the scores divided by the number of scores being summed. Mean () = N = 35 10 = 3.5.

DIF: Cognitive Level: Analysis REF: MCS: 555

3. The median is represented by which score for the following data set?

Data set: 1, 2, 4, 7, 7, 8, 10, 10, 10, 18

a. 10 b. 8 c. 7.5 d. 7 ANS: C The median (MD) is the score at the exact center of the ungroupe d frequency distribution. It is the 50th percentile. To obtain the MD, sort the values from lowe st to highest. If the number of values is an uneven number, exactly 50% of the values are above the MD and 50% are below it. If the number of values is an even number, the MD is the average of the two middle values. The median for this set is 7.5, since the data set contains an even number of values, and the two numbers in the middle are 7 and 8. Their average is 7.5.

DIF: Cognitive Level: Analysis REF: MCS: 553

4. Which of the following measures is the most helpful both for providing a quantification of dispersion and for providing a way to interpret how far away from the mean each individual score is?

a. Standard deviation b. Difference scores

c. Range d. Magnitude ANS: A Measures of dispersion, such as the r ange, difference scores, variance, and standard deviation, provide important insight into the nature of the dat a. The st andard deviation is an important statistic, both for understanding dispersion within a distribution and for interpreting the relationship of a particular value to the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 554

5. Which of the following measures is merely a simple difference score? a. Standard deviation = 2.41 b. Difference scores = 2, 2, 1, +2, and +3 c. Range = 8 d. Variance = 5.80 ANS: A The simple st measure of dispersion is the r ange. In published studies, range is presented in two ways: (1) the range is the lowe st and highe st scores, or (2) the range is calculated by subtracting the lowest score from the highest score. In this form, the range is a difference score that uses only the two extreme scores for the comparison. The range is generally reported in published studies but is not used in further analyses.

DIF: Cognitive Level: Analysis REF: MCS: 554

6. The data set is: 2, 3, 6, 7, 12. A me asure of dispersion is calculated, and it is about 3.5. What is this measure of dispersion?

a. The difference score b. The variance c. The range

d. The standard deviation ANS: D The definition of standard deviation (SD) is the average difference between the mean and e ach of the scores in the set. Standard deviation (SD) is a measure of dispersion that is t he square root of the variance. S D is the most precise analysis technique for ex amining the distribution of scores. S D includes difference score s in it s calculation but does not involve the use of standardized scores.

DIF: Cognitive Level: Application REF: MCS: 555

7. The data set is as follows: Ford, Ford, Chevy, Toyota, Ford, Ford, Chevy, Dodge, Dodge, Dodge, Ford, Subaru, Chevy, Toyota, Chevy. What measures of central tendency and dispersion will be used with this set?

a. Difference scores b. Range c. Median d. Mode ANS: D The data are not inherently numerical in nature and represent only a nominal level of measurement. None of the listed measures of variability are suit able for nominal-le vel data. The mode is the only measure of central tendency appropriate for nominal dat a. The mode is the numerical value or score that occur s with the greatest frequency in a data set.

DIF: Cognitive Level: Application REF: MCS: 552

8. Twenty student nurses take the NCLEX examination. If the average of the twenty score s is known, how many degrees of freedom are there in the sample?

a. 18 b. 19

c. 20 d. 21 ANS: B The concept of degrees of freedom was used originally in reference to computing a confidence interval, but it applie s to any statistical computation. Degrees of freedom are the number of independent pieces of information that are free to vary in order to estimate another piece of information. If, for instance, the mean and the tot al n are known, if all of the value s except one are known, the last one can be calculated. However, if all except two are known, one has the freedom to vary, and the other one s value is then set. In calculations, the degrees of freedom (df) are n 1. This means that there are n 1 independent observations in the sample of n dat a points that are free to vary (to be any value).

DIF: Cognitive Level: Application REF: MCS: 558 MULTIPLE RESPONSE

1. The Stanford Binet Intelligence Quotient is a normed intelligence test, and its IQ me asures are quite normally distributed. Its standard deviation is 16. I f the test were perfectly normal in its distribution, this would mean which of the following? (Select all that apply.)

a. There are more people with IQs of 100 than any other number. b. For every person with an IQ of 120, there is one with an IQ of 80. c. More than 95% of people have IQs between 68 and 132. d. If someones IQ is me asured as 109, and year s later it is measured as 112, some one elses IQ has dropped three points.

e. About 14% of people have IQs between 117 and 132. f. Excluding people with IQs of exactly 100, half of the remainder have IQs lower than 100, and the other half have IQs higher than 100.

ANS: A, B, C, E, F The normal curve is a per fectly symmetrical frequency distribution. The value at the exact center of a normal curve is the mean of the values. When a frequency distribution is shaped like the

normal cur ve, we know that 34.13% of the subjects scored between the mean and 1 standard deviation above the mean and 34.13% of the subjects scored between the mean and 1 standard deviation below the mean. This means that 68.26% of the subject s scored between 1 and +1 standard deviations. Because the normal curve is perfectly symmetrical, it is known that 50% of the subjects scored above the mean, and 50% of the subject s scored below the mean.

Furthermore, 95.44% of the subjects scored between 2 and +2 standard de viations. DIF: Cognitive Level: Synthesis REF: MCS: 555

2. Female graduate nurses scored an average of 89% on the first midterm examination. Male graduate nur ses also scored an average of 89% on the first midterm examination. What does this mean? (Select all that apply.)

a. The same number of men and women failed the test. b. If the passing score is 75%, fewer students failed in both groups than the number that passed.

c. The overall combined average on the midterm, for both classes, is 89%. d. Both classes have the same range. e. Both classes have identical variances and standard deviations. f. The median score is the same for both classes. g. The mode score is the same for both classes.

ANS: B, C The most commonly used me asure of central tendency is the mean. The me an is the sum of the scores divide d by the num ber of scores being summed. Conse quently, it provides an average of the scores for e ach gr oup.

Combination of the groups pr ovide s the same group mean, since the me ans are identical. The value s for mode and median are not provided, so no conclusions can be drawn about these. Me asures of dispersion (standard deviation, range, variance) are not provided, and cannot be assumed to be identical between groups. Since 100% (the highest possible passing score) and 74.9% (the highest possible failing score) average 87.5% and the overall combined mean is higher than this, more students passe d than failed in both groups, and this is true, as well, for the combined group.

DIF: Cognitive Level: Synthesis REF: MCS: 553

3. Descriptive statistics are found in which of the following? (Select all that apply.) a. All quantitative descriptive research reports b. Some qualitative research reports c. All quantitative inferential research reports d. No qualitative research reports e. Some quantitative inferential research reports ANS: A, B, C For some type s of studies, de scriptive st atistics will be the only approach to analysis of the data. For other studies, de scriptive st atistics are the first ste p in the data analysis proce ss, to be followed by inferential statistics.Data analysis begins with de scriptive statistics in any study in which the data are numerical, including some qualitative studies.

DIF: Cognitive Level: Application REF: MCS: 550 4. There is a data set A: 3, 3, 3, 5, 6, 6, 8, 9, 9, 12, 1 3. The data set B is created.

It is identical to A, except for its much larger last value. Data set B: 3, 3, 3, 5, 6, 6, 8, 9, 9, 12, 83.

What is the effect of increasing the largest value upon the descriptive st atistics of the dat a set? (Select all that apply.)

a. The mean increases. b. The median increases. c. The mode increases. d. The sets distribution changes from perfectly normal to somewhat skewed. e. The standard deviation increases.

f. The variance increases. g. The range increases.

ANS: A, D, E, F, G The mode is the numerical value or score that occurs with the greatest frequency in a data set; unless this is the largest value, the mode will be unaffected. The median ( MD) is the score at the ex act center of the ungr ouped frequency distribution; it is unaffected by a change in the value of the large st value. The me an is the arithmetic average of all a variable s values in a study and is the most comm only reported measure of central tendency. The mean is sensitive to extreme scores such as outliers, and it will be affected by a large increase in the large st value. Me asure s of dispersion or variability are measures of individual differences of the members of the population and sample. Since they indicate how different the scores are, they all are affected by an extreme value.

DIF: Cognitive Level: Evaluation REF: MCS: 552

5. The confidence interval for five-year survival after Stage I breast cancer in a large sample of women living in Texas is 87.5% to 93.3%, at a p <.05 level of significance. What does this mean? (Select all that apply.)

a. Texan women in the near future will be likely to have about a 90% chance of living five years after they are newly diagnosed with Stage I breast cancer.

b. Women in Texas with Stage I breast cancer have a 95% chance of 90% survival, over a fiveyear period.

c. Women in Texas with Stage I breast cancer have an 86% chance of five -year survival. d. In any sample of women in Texas ne wly diagnose d with Stage I breast cancer, there is about a 95% chance that their collective survival five years from now will be around 90%.

e. Women in Texas can feel 95% confident that they will survive Stage I breast cancer.

ANS: A, D

To determine how closely the sam ple mean appr oximates the population mean, the standard error of the mean is used to build a confide nce interval. For that matter, a confidence interval can be created for m any statistics, such as a mean, proportion, and odds ratio. At the p < .05 level, it merely signifies that there is a window of possibilities, and future samples have a 95% chance of falling within that window.

DIF: Cognitive Level: Application REF: MCS: 558

6. A researcher wants t o select a way to me asure how values in a re search study are dispersed around the mean, and how homogeneous or heterogeneous they are, for a ratio-level variable. The researcher might select which of the following? (Select all that apply.)

a. Mode b. Range c. Frequency distribution d. Mean e. Standard deviation ANS: B, E Measures of dispersion or variability are measures of individual differences of the members of the population and sample. They indicate how value s in a sample are dispersed around the mean. These measures pr ovide information about the data that is not available fr om measures of ce ntral tendency. They indicate how different the scores arethe extent to which individual values deviate from one another. If the individual values are similar, measures of variability are small and the sam ple is relatively homogene ous in terms of those value s. When there are wide variations or differences in the scores, the sam ple is considered heterogeneous.

The heterogeneity of sample scores or values is determined by measures of dispersion or variability. The measures of dispersion m ost commonly reported in nursing research are range, difference scores, variance, and standard deviation. All are useful for ratio-level data.

Chapter 23: Using Statistics to Examine Relationships Test Bank

MULTIPLE CHOICE

1. Which of the following correlation coefficients shows the strongest relationship? a. .10 b. .85 c. .80 d. .42 ANS: B Pearsons pr oduct-m oment correlation is represented by the letter r, and the value of the r is always between 1.00 and +1.00. A value of zero indicates no relationship between the two variable s. The further the value from zero, the stronger the relationship. The number indicate s the strength of the relationship, and the sign connotes whether that relationship is positive or negative (inverse). Consequently, a relationship of .60 is exactly as strong as a relationship of .60, although one is a positive relationship and the other a negative , or inverse , one . Values gre ater than .50 or less than .50 indicate strong correlations.

DIF: Cognitive Level: Analysis REF: MCS: 561

2. The Pearson product-moment correlation for two variables, fear of embarrassment and anxiety just before making an oral present ation, is r = .78, with a coefficient of determination of 0.6084. This means that what percentage of anxiety just before making an oral presentation can be attributed to fear of embarrassment?

a. About 0.61% b. About 61% c. About 0.78 d. About ANS: B

78%

One can also assess the magnitude of association by obt aining the coefficient of determination for the Pearson correlation. Com puting the coefficient of determination simply involve s squaring the r value. The r2 (multiplied by 100%) represents the percentage of variance shared between the two variable s. In other words, the coefficient of determination explains how much of the change in value of one variable can be attributed to the fluctuation in value of the other variable.

DIF: Cognitive Level: Analysis REF: MCS: 564

3. What does the correlational diagram X Y mean? a. X obviously precedes Y in time. b. X is interchangeable with Y. c. There is a relationship between X and Y. d. Either X causes Y, or Y causes X. ANS: C Correlational analyse s identify relationships or associations among variable s. In the diagram, the arrow point s to both variable s, further confirming that one doe snt cause the other: X is merely related to Y and nothing more.

DIF: Cognitive Level: Comprehension REF: MCS: 560

4. A researcher develops a new instrument for measuring adjustment to widowhood in dependents whose spouse s were kille d in armed conflict. The researcher s initial instrument contains 55 items, and he wants to trim these down to 25 or 30 but doesnt want to lose any of the main concepts. What method of statistical analysis will the researcher use, in order to pare this tool down to a manageable size without loss of content?

a. Kendalls tau b. Spearmans rho c. Linear regression analysis d. Factor analysis

ANS: D Factor analysis is one of the st atistical technique s designed to examine interrelationships among large numbers of variable s to reduce them to a smaller set of variables, and to identify clusters of variable s that are most closely linked together (factors).

DIF: Cognitive Level: Application REF: MCS: 566

5. A study examines the relationship between strength of belief in previous lives (Yes, Not Sure, and No) and percentage of butterfat in milk m ost commonly purchased (Non-Fat, 1%, 2%, Whole). The dat a could be analyzed by which of the following statistical tests?

a. Kendalls tau b. Pearsons product-moment correlation c. Principal components analysis d. Bland and Altman plot ANS: A If one or both of two study variable s do not meet the assumptions for a Pearsons correlation, or if the variables are scale d on an ordinal scale of measurement (rather than interval or ratio), both the Spearm an rank order correlation and Kendalls t au are more appropriate st atistics. The S pearman r ank-order correlation and Kendalls tau calculations involve converting the data to ranks, thereby discarding any variance or normality issues associated with the original values.

DIF: Cognitive Level: Analysis REF: MCS: 560

6. A Pearsons correlational analysis examines the relationship between variable A, hours of sleep per week, and B, sym ptom severity, in 43 women with post-polio syndrome. In acce ssing the table of values, the researcher uses which of the following numbers for degrees of freedom?

a. 2 b. 4 c. 41

d. 43 ANS: C Every inferential st atistic has is own formula for degrees of freedom (numbers of values that are free to vary).

The formula for degrees of freedom (df) for a Pearson r is n 2. Thus, in this case, the df is 43 2 = 41.

DIF: Cognitive Level: Analysis REF: MCS: 563 MULTIPLE RESPONSE

1. In the results and conclusions sections of a rese arch paper about pre-delinquent behavior, the researcher mentions the strong correlational relationship between the number of incidents of pre - delinquent behavior and the number of hours the mother works outside the home. What does the author imply by stating this?

(Select all that apply.)

a. Some sort of test of correlation was performed and it reached statistical significance.

b. As number of hour s worked out side the home varied, so did the frequency of incident s of pre-delinquent behavior.

c. Having a mother work many hours outside the home causes pre-delinquent behavior. d. Incidents of pre-delinquent behavior cause mother s to work more and more hours outside the home.

e. As number of hours worked outside the home increased, so did the frequency of incidents of pre-delinquent behavior.

f. The researchers avoided a type II error, in relation to the association between the se two variables.

g. The researchers operationalized the two study variables.

ANS: A, B, F, G Correlational analysis pr ovide s two piece s of inform ation about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship. No direction of relationship is stated heremerely the fact that

the variables are strongly correlated, me aning that as one varied, the other varied. Since the relationship between these two variables was statistically significant, no type II error occurred. The probability of failing to reject the null hypothe sis when it is in fact false is called type II error, and it is related to using a sample that is of insufficient size. Operationalization of a variable indicates how it will be measured or m anipulated in a study; without operationalization, no measurement can occur.

DIF: Cognitive Level: Synthesis REF: MCS: 561

2. In the results and conclusions sections of a research article about adult morbid obe sity and a history of being underweight during the fir st two years of life , the researcher mentions the strong negative correlation between these two variables. What does the author imply by stating this? (Select all that apply.)

a. Some sort of test of correlation was performed and it reached statistical significance.

b. A person with morbid obesity is more likely than someone without it to have been underweight during the first two years of life.

c. A person with morbid obesity is less likely than some one without it to have been underweight during the first two years of life.

d. Having been underweight during the first two year s of life prevent s morbid obesity in adulthood.

e. The researchers avoided a type I error, in relation to the association between these two variables.

f. The researchers operationalized the two study variables.

ANS: A, C, E Correlational analysis provides two pieces of inform ation about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship. In a negative linear relationship, when one value is high, the other value tends to be low. The probability of rejecting the null hypothe sis when it is in fact true is called type I error, and it is impossible to know whether it has occurred until replication research take s place. Operationalization of a variable indicates how it will be measured or manipulated in a study; without operationalization, no measurement can occur.

DIF: Cognitive Level: Synthesis REF: MCS: 561

3. What does bivariate correlational analysis do? (Select all that apply.) a. Provides an idea of which variable causes the other one b. Reflects a two-way connection or pattern c. Measures the strength of multiple relationships connected with a concept d. Measures the strength of the relationship between two variables e. Determines the direction of the relationship between two variables ANS: B, D, E Bivariate correlational analysis measures the magnitude of linear relationship between two, and only two, variables and is per formed on data collected from a single sample . Correlational analysis provides two pieces of information about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship.

DIF: Cognitive Level: Comprehension REF: MCS: 560

4. What is the connection between a scatter plot and a calculation of correlation? (Select all thatapply.) a. Constructing a scatter plot allows the researcher to visualize in advance whether a calculation of linear correlation is likely to reveal a relationship between the variables.

b. Constructing a scatter plot produce s a correlation coefficient, as does calculating correlation.

c. A calculation of correlation should be performed be fore constructing a scatter plot, because the calculation is more scientific.

d. The scatter plot provides a visual represent ation of the connection between two variables; a correlational calculation provides a quantification of the connection between the same variables.

e. Just like calculation of correlation, constructing a scatter plot provides a way to quantify explained variance.

ANS: A, D Scatter plots or scatter diagram s provide useful preliminary information about the nature of the relationship between variables. The researcher should de velop and examine scatter diagr ams before performing correlational analysis. Scatter plots m ay be use ful for selecting appr opriate correlational procedures, but most correlational procedures are useful for examining linear relationships only. A scatter plot can easily identify nonlinear relationships; if t he dat a are nonline ar, the researcher should select statistical alternatives such as nonline ar regression analysis. A scatter plot is created by plotting the value s of two variables on an x and y axis.

DIF: Cognitive Level: Analysis REF: MCS: 560

5. For which of the following levels of measurement would a parametric statistical test like the Pear son product-moment correlation be used?

a. Nominal level b. Ordinal level c. Interval level d. Ratio level e. Dichotomous ANS: C, D The Pearson product-moment correlation coefficient is conducted to determine the relationship between two variables me asured at least at the interval le vel of me asurement. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when dat a can be organized into categories of a defined property but the categories cannot be ordered. In interval level of measurement, distance s between intervals of the scale are numerically equal.

Howe ver, it is not possible to pr ovide the absolute amount of the attribute because of the absence of a zero point that actually means none of the measured quantity, on the interval scale . Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures: mutually exclusive categories, exhaustive categories, rank ordering, equal spacing between intervals, and a continuum of values.

In addition, ratio-level measures have absolute zero points.

DIF: Cognitive Level: Analysis REF: MCS: 561

6. Which of the following variables are able to be analyzed using Pear sons product -moment correlation?

(Select all that apply.)

a. Age b. Race c. Gender d. Score on the Spielberger State Trait Anxiety Inventory e. Years of education f. Temperature g. Nickname h. Size of hospital gown worn ANS: A, D, E, F Use of the Pearson product-m oment correlation assumes that the variables are at the interval or ratio level of measurement. In this example , they would be only the four: age, score on the STAI, ye ars of education, and temperature. Nominal level of measurement is the lowe st of the four me asurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be or dered.

In interval level of measurement, distances between intervals of the scale are numerically equal. However, it is not possible to pr ovide the absolute am ount of the attribute because of the absence of a zero point that actually means none of the measured quantity, on the interval scale. Ratio level of measurement is the highe st form of measure and meets all the rules of the lower form s of measures: mutually exclusive categories, exhaustive categorie s, rank ordering, equal spacing between intervals, and a continuum of values. In addition, ratio-level measures have absolute zero points.

DIF: Cognitive Level: Application REF: MCS: 561

7. Twelve research studie s show a strong correlation between low levels of education and poverty. A social scientist declares that the cure for poverty is in free education for all of the children of the poor. What are valid arguments against this declaration? (Select all that apply.)

a. The scientist believes that a low level of education, in and of itself, causes poverty, but no study has demonstrated this.

b. It is possible that low levels of education cause Item B, and Item B causes poverty. c. It is possible that multigenerational poverty causes lower levels of education. d. It is possible that low levels of education and poverty are both caused by social injustice. e. Twelve correlational research studies are not enough to demonstrate cause: at least 50 studies of 100 subjects each would be required for this.

ANS: A, B, C, D Correlational analysis provide s two pieces of information about the dat a: the nature or direction of the linear relationship (positive or negative) between the two variable s and the magnitude (or strength) of the linear relationship. A positive correlation is not an indication of causality, no matter how strong the statistical result.

DIF: Cognitive Level: Application REF: MCS: 561

8. The calculated Pear sons r was .95 in a rese arch study on num ber of hour s parents spent at childrens sporting e vents and number of arrests those children had experienced by age 30. What doe s this Pear sons value signify? (Select all that apply.)

a. No relationship b. Weak linear relationship c. Moderate linear relationship d. Strong linear relationship e. Positive relationship f. Inverse relationship g. Negative ANS: D, F, G

relationship

Pearsons pr oduct-m oment correlation is represented by the letter r, and the value of the r is always between 1.00 and +1.00. A value of zero indicates no relationship between the two variable s. The further the value from zero, the stronger the relationship. The number indicate s the strength of the relationship, and the sign connotes whether that relationship i s positive or negative (inverse). Consequently, a relationship of .60 is exactly as strong as a relationship of .60, although one is a positive relationship and the other a negative, or inverse , one . Values gre ater than .50 or less than .50 indicate strong correlations.

Chapter 24: Using Statistics to Predict Test Bank MULTIPLE CHOICE

1. A researcher is studying daily carbohydrate int ake and the next days first morning Accu-Chek value . After drawing a scatter plot, the rese archer develops a multiple regression equation. What doe s the value R represent?

a. The line of best fit b. The amount of change in Accu-Chek values that daily carbohydrate intake predicts c. Daily carbohydrate intake times Accu-Chek value d. The correlation between daily carbohydr ate intake and the next days first m orning Accu-Chek value ANS: D R is defined as the correlation between the actual y values and the predicted y values using the new regression e quation. The R2 represent s the percentage of variance in y explaine d by the predictor and is called the coefficient of determination.

DIF: Cognitive Level: Application REF: MCS: 572

2. A researcher is studying stress and various factors that seem to be related to it, in women with terminally ill spouse s.Am ong other things, the researcher finds out that depression contribute s to total stress; depre ssion contributes to lack of exercise; a decreased amount of exercise

contributes to depre ssion; exercise relieves stress; guilt contributes t o depre ssion; exercise has no e ffect on guilt, but it affects total stress; stress worsens depression; and stress decreases motivation t o perform exercise. This is an example of what problem commonly encountered in regression analyses?

a. Multicollinearity b. Hazard ratio c. Odds ratio d. Predictive validity ANS: A Multicollinearity occurs when the inde pendent variable s in a multiple regression equation are strongly correlated with one another. The presence of multicollinearity does not affect predictive power; rather it cause s problems related to generalizability and the stability of the findings. The first ste p in identifying multicollinearity is to examine the bivariate correlations among the independent variables.

DIF: Cognitive Level: Application REF: MCS: 573

3. Why does a researcher decide to calculate odds ratio instead of calculating linear regression when comparing whether a person voted in the last election and the persons gender?

a. Voting records are sealed. b. Both predictor and dependent variable are dichotomous. c. Odds ratio is a simpler calculation. d. Strength of relationship is not an issue.

ANS: B When both the predictor and the depende nt variable are dichotom ous (having only two values; also called binary), the odds ratio is a comm only used statistic to obtain an indication of association. Linear regression is used to determine relationships with interval or ratio dat a. The odds ratio (OR) is de fined as the r atio of the odds of an event occurring in one group to the odds

of it occurring in another group. Put sim ply, the OR is a way of com paring whether the odds of a certain event is the same for two groups.

DIF: Cognitive Level: Analysis REF: MCS: 575 MULTIPLE RESPONSE

1. A researcher collects a nationally based set of dat a about chole sterol levels and age at fir st circulatory incident (myocardial infarction or cerebrovascular accident). The researcher performs a linear regression analysis in order to do which of the following? (Select all that apply.)

a. Estimate the age at which circulatory incident s are likely t o occur, given the cholesterol level.

b. Determine how well the data fit the theoretical framework. c. Calculate the strength of the relationship between cholesterol levels and circulatory incidents.

d. Determine whether there is a linear relationship between cholesterol levels and circulatory incidents.

e. Derive the formula for the line of best fit. f. Obtain information from which to construct a better scatter plot.

ANS: A, C, D, E Simple linear regression pr ovide s a means to estimate the value of a dependent variable based on the value of an inde pendent variable . Through regression, the strength of the relationship between two variables can be determined. Simple linear regression is an e ffort to explain the dynamics within the scatter plot by developing a formula for a straight line that best fits the data. This has nothing to do with a theoretical fr amework. A scatter plot precedes development of a regression formula.

DIF: Cognitive Level: Application REF: MCS: 570

2. A researcher is studying num ber of cats in the home, and num ber of rodents plus cr awling insects in the home, daily carbohydrate intake and the next days fir st morning Accu -Che k value. After drawing a scatter plot, the researcher develops a multiple regression equation and

determines R as .75 and R2 as .5625. What does the calculated value R2 represent? (Select all thatapply.)

a. It means the standard error, squared. b. It is the amount of rodent plus insect count that can be explained by the number of cats. c. It stands for the standard deviation of the data set y, squared. d. It estimates shrinking regression. e. It is the coefficient of determination. f. It is the explained variance.

ANS: B, E, F R is defined as the correlation between the actual y values and the predicted y values using the new regression equation. The R2 represents the percentage of variance in y explained by the predictor and is called the coefficient of determination.

DIF: Cognitive Level: Application REF: MCS: 573

3. Which of the following terms in correlational research mean the same thing? (Select all that apply.) a. Predictor variable b. Dichotomous variable c. Dependent variable d. Multicollinearity e. Independent variable ANS: A, E The independent (predictor) variable or variable s are identified as being predictive of variation in the value of the dependent (outcome) variable. Multicolline arity refers to highly correlated predictor variables that are difficult to tease out from one another. A dichotomous variable has only two possible values.

DIF: Cognitive Level: Comprehension REF: MCS: 574

4. A researcher conduct s research on optimism. The researcher is calculating a multiple regression equation to predict levels of optimism and wishes to consider religious affiliation as one of the predictor variable s. The researcher creates several dummy variables for this purpose. Why must this be done? (Select all that apply.)

a. It is safer to create more variables than fewer, since they may each contribute. b. Multiple regression requires that the researcher enter numerical values, not names such as Lutheran, Orthodox Jewish, Buddhist, Islamic, and so forth.

c. Reducing nominal or categorical data to one or a series of dichotomous values allows mathematical computation of the regression equation.

d. Religious affiliation is a protected entity under HIPAA and must be coded before it is used in calculations.

e. The researchers aim is to develop a formula with which to calculate optimism , given certain other variables, so these must all be represented as numbers.

ANS: B, C, E Variables in a regression equation can take many form s. Traditionally, as with most multivariate analyse s, variables are measured at the interval or ratio level. However, rese archers also use categorical or dichotom ous variables, by assigning the terms num bers to repre sent them (referred to as dummy variable s). These numbers are further converted to binary numbers; after this, they are entered one digit at a time as a series of dummy variables. For instance , if a nominal or categorical variable has two value s, one dummy variable m ay be used (0, 1). If a nominal or categorical variable has three or four value s, howe ver, two different dummy variables are used torepresent them. For five to eight values, three dummy variables are used, and so forth.

DIF: Cognitive Level: Analysis REF: MCS: 574

5. What is a multiple regression equation? (Select all that apply.) a. One that represents the mathematical effect that several independent variable s have on the dependent variable

b. One in which the x-values are multiplied by one another

c. One that explains more of the variance in y than does a single linear regression equation d. An experimental model for determining best practices e. One that uses more than one predictor variable to predict the value of the outcome variable f. One that explains all of the variance in the dependent variable, in terms of several independent variables ANS: A, C, E Multiple regression is an extension of sim ple linear regression in which more than one independent variable is entered into the analysis. Because the relationships between multiple predictor s and y are tested simultaneously, the calculations involved in multiple regression analysis are very complex. Multiple regression is be st conducted using a statistical software package. A multiple regression formula explains some or all of the variance in the dependent variable; it cannot explain all of it.

DIF: Cognitive Level: Analysis REF: MCS: 573

6. Why does a researcher decide to use logistic regression instead of line ar regression to calculate sur vival odds after suffering an out-of-hospital heart attack, in persons of various age s, genders, and cardiac diagnoses?

(Select all that apply.)

a. Survival versus non-survival is a dichotomous variable. b. Having a heart attack is a variable that has many possible outcomes. c. Linear regression is less logical than is logistic regression. d. Age is a ratio-level variable. e. Gender is a nominal-level variable. f. Cardiac diagnosis is a nominal-level variable.

ANS: A, D, E, F Logistic regression replace s linear regression when the researcher wants to test a predictor or predictors of a dichotomous dependent variable. Logistic regression can have continuous

predictors or nominal predict ors or a combination of the two, with no assumptions regar ding normality of the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 576

7. Which of the following dependent variables is suitable for logistic regression analysis? (Select all that apply.) a. How many compressions were delivered in the first minute post-code b. Serum sodium value c. Born on earthnot born on earth d. Height at adulthood e. Birth gender f. Whether a patient with cancer goes into remission ANS: C, E, F Logistic regression replace s linear regression when the researcher wants to test a predictor or predictors of a dichot omous dependent variable. Logistic regression can have continuous predictors or nominal predictors or a combination of the two, with no assumptions regarding normality of the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 576

8. A researcher decides to study how many college freshmen with continuous enrollment graduate within four year s, four-and-a-half ye ars, five ye ars, five-and-a-half ye ars, and six years, and to analyze this accor ding to what their major s at gr aduation are, as well as other demographic variable s. Why would a Cox pr oportional hazards regression analysis be suitable for this research? (Select all that apply.)

a. Demographic variables could affect time until graduation. b. The data of people who do not graduate at all may be informative. c. Attendance at college can present hazard. d. A predictor of the dependent variable is time-related.

e. Only people who actually graduate by the end of twelve seme sters will have their data analyzed.

ANS: A, B, D The purpose of a regression analysis is to predict or explain as much of the variance in the value of a dependent variable as possible. The major difference between using Cox re gression as opposed to linear regression is the ability of survival analysis to handle case s where survival time is unknown. Whereas logistic regression yields odds ratios for each predictor to represent the relationship between that predict or and y, Cox regression yields hazard ratios.

DIF: Cognitive Level: Application REF: MCS: 570

9. Which of the following statements about prediction is true? (Select all that apply.) a. Simple linear regression can predict possible changes in A, given B. b. Multicollinearity is used to provide definitive attribution in predicting dependent variables with similar outcomes.

c. Multiple regression can provide information about the stronge st predictor s, C, D, E, and F, associated with an outcome variable G.

d. Odds ratio is used t o predict the likelihood of a dichotom ous event, in the light of a different dichotomous variable.

e. Logistic regression is used to predict a dichotom ous variable, using a variety of other variables.

f. Cox hazard regression can predict the likelihood of an e vent occurring at certain points in time.

ANS: A, C, D, E, F Simple linear regression provides a means to estimate the value of a dependent variable based on the value of an independent variable. Multicollinearity occurs whe n the independent variables in a multiple regression equation are strongly correlated with one another. Multiple regression is an extension of simple linear regression in which more than one independent variable is entered into the analysis. When both the predictor and the dependent variable are dichot omous (having only two value s; also called binary), the odds r atio is a commonly used statistic to obtain an indication of association. Logistic regression replace s linear regression when the researcher wants to test a

predictor or predictor s of a dichotom ous depende nt variable. Logistic regression can have continuous predictors or nominal predictors or a combination of the two, with no assumptions regarding normality of the distribution. The major difference between using Cox regression as opposed to line ar regression is the ability of survival analysis to handle cases where survival time is unknown. Whereas logistic regression yields odds ratios for each predictor to represent the relationship between that predictor and y, Cox regression yields hazard ratios.

Chapter 25: Using Statistics to Determine Differences Test Bank MULTIPLE CHOICE

1. What does the two-way chi-square test measure? a. Whether one variable seems related to another one b. Whether two variables cause one another c. Whether an intervention changes the dependent variables value d. Change over time ANS: A The chi-square (c) test compares differences in proportions of nominal level variables. A two - way chi-square is a statistic that tests whether proportions in levels of one variable are significantly different from proportions of the second variable. In other words, it detects whether one nominal variable seems t o be related to another one.

DIF: Cognitive Level: Analysis REF: MCS: 587

2. In an ANOVA calculation evaluating causation, the mean square within groups value represe nts the ordinary amount of variation that exists in the data set. What does the mean square between groups value represent?

a. The effect that the interventional conditions produce b. The average of all variations in the data set

c. Total variation d. The differences that exist among the several interventional conditions ANS: A The term mean square (MS) is use d interchangeably with the word variance. The formulas for ANOVA compute two estimate s of variance: the between groups variance and the within groups variance. The between groups variance represent s differences between the groups/conditions being com pared, and the within groups variance represents differences among (within) each groups data. Therefore, the formula is F = MS between/MS within.

DIF: Cognitive Level: Analysis REF: MCS: 585

3. Which of the following tests is essentially a comparison of means? a. Mann-Whitney U b. Chi-square c. ANOVA d. t-test ANS: D One of the most comm on parametric analyse s used to test for significant diffe rences between group means of two sample s is the t-test. In its calculation, the numerator is the difference scores of the means of the two samples. In addition, the test uses the pooled standard deviation of the two samples as the denominator.

DIF: Cognitive Level: Comprehension REF: MCS: 580

4. Why is post hoc statistical testing not performed with a two-group ANOVA? a. A researcher is reluctant to perform a post hoc analysis that would require a more stringent level of significance.

b. The F-statistic would be invalidated by the second test.

c. If hypothesis testing reveals that a difference between groups exists, it is obvious what two groups those are.

d. Sample sizes are not large enough for this analysis.

ANS: C Post hoc test s have been developed specifically to determine the location of group differences after ANOVA is performed on data from more than two groups. The post-hoc analyse s performed after the ANOVA preserves the same level of analysis as the ANOVA it self. The F- statistic is not invalidated by performing a post hoc analysis. Sample size is not a consideration when performing a post hoc analysis.

DIF: Cognitive Level: Analysis REF: MCS: 586

5. What is unique about chi-square analysis? a. It is almost always statistically significant. b. It is used for two nominal variables c. It demands normal distribution, even of dichotomous variables. d. It is parametric.

ANS: B The chi-square (c) test compares differences in proportions of nominal level variables. Statistical significance may or may not exist. The test does not demand normal distribution, and it is non- parametric.

DIF: Cognitive Level: Analysis REF: MCS: 587 MULTIPLE RESPONSE

1. Below the third table in a rese arch report, concerning switching infants to cows milk at six months of age instead of 12 months, is a notation: t(22) = 0.76, p = .41 What does this mean? (Select all that apply.)

a. A t-test was performed. b. Apparently 24 subjects participated in the study. c. There was a difference between groups. d. The difference between groups was not statistically significant. e. If there was an intervention, the intervention was more effective than the control condition. f. The results are generalizable. g. The researcher failed to reject the null hypothesis. h. A type I error occurred.

ANS: A, B, C, D, G One of the m ost comm on parametric analyses used to test for significant differences between group me ans of two samples is the t-test. It is conducted to discover whether a difference exists between two groups, or between a previous condition and the current condition in paired subjects. Degrees of freedom are equal to n 2. Not enough is known about the research to discern in which group the intervention was more effective. In this example, there was a difference between groups, but it was apparently not statistically significant, since p = .41, according to the notation below the graph. Only p-values of .05 and less would be statistically significant .

If the researcher failed to reject the null hypothesis, no type I error could have occurred.

DIF: Cognitive Level: Synthesis REF: MCS: 580

2. A researcher is studying the effect upon pain of pr oviding hypnosis with dental work. The researchers three groups are (1) hypnosis before and during the procedure, (2) hypnosis before but not during the procedure, and (3) no hypnosis. If the researcher plans to use an ANOVA for the statistical analysis, which would be an acceptable way to measure pain, for this study? (Select all that apply.)

a. Present versus absent b. Worse Some A Lot Unbearable c. 0- to 100-point verbal numerical scale d. Systolic blood pressure readings

e. The force with which the subject squeezes a rubber ball with pressure gauge attached ANS: C, D, E The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-te st, paired or dependent sample s t-test, and analysis of variance (ANOVA). ANOVA requires that the dependent variable be at the interval or ratio level: a verbal numerical scale, systolic blood pressure readings, and force with which the subject squeezes a rubber ball are all interval or ratio level variables.

DIF: Cognitive Level: Analysis REF: MCS: 580

3. A statistician me asure s the difference in songbird war ble variation in twenty-five m ockingbirds, both before and after nutritional supplementation with Dr. Petit Oise aus Musical Bird Seed. W arble variation is determined by a computer program that detects sound freque ncy and pattern change s during a 15-minute period twice a day, and this data is averaged to repre sent number of warble variations per minute. What considerations determine choice of a test for this research? (Select all that apply.)

a. The sample size is small to moderate. b. There is one group of birds and all receive the treatment. c. A before-after type of design is used. d. The independent variable is nominal level. e. Birds are divided into two groups. f. The independent variable is ratio level. g. The dependent variable is ratio level.

ANS: A, B, C, D, G The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonpar ametric analyse s of Mann-Whitney U, Wilcoxon signed-ranks test,

and Kruskal-Wallis H are appropriate techniques t o use to test the rese archers hypothese s. In this study, one group is compared be fore and after treatment. In such an inst ance, a paired t-test can be use d, if the dependent variable is at the ratio or interval level. This test is particularly useful when only sm all sample s are available for analysis; the sample is large enough.

DIF: Cognitive Level: Analysis REF: MCS: 580

4. A statistician measures the difference in songbird warble variation in twenty-five mockingbirds, both before and after nutritional supplementation with Dr. Petit Oiseaus Musical Bird Seed. Warble variation is determined by a cranky librarian, who char acterizes the birds, before and after treatment, as one of the following Lots of Note s There! Fair Variety, and Quite The Redundant Little Song. What considerations determine choice of a test for this research? (Select all that apply.)

a. The sample size is small to moderate. b. There is one group of birds and all receive the treatment. c. A before-after type of design is used. d. The independent variable is nominal level. e. Birds are divided into two groups. f. The dependent variable is ordinal level. g. The dependent variable is ratio level.

ANS: B, C, D, F The parametric statistics use d to determine difference s that are covered in this chapter are the independent samples t-test , paired or depende nt sam ples t-test, and analysis of variance (ANOVA). If the assum ptions for parametric analyses are not achieve d or if study data are at the ordinal level, then the nonparametric analyses of Mann-Whitney U, Wilcoxon signe d-ranks test, and Kruskal-W allis H are appropriate technique s to use to te st the researchers hypothese s. In this study, one group is compared before and after treatment, and the dependent variable is at the ordinal le vel of measurement. In such an inst ance, a Wilcoxon signed-ranks test is appropriate.

This test is useful when a paired t-test would otherwise be performed, if only the dependent variable werent ordinal.

DIF: Cognitive Level: Analysis REF: MCS: 580

5. A researcher designs a study to measure whether receiving a free season pass to a beautiful ski resort near Bountiful, Ut ah, incre ase s the number of days a subject who has lived in the area for 1 to 3 ye ars skis during the season. An independent samples t-test of correlation is used to measure the effect of receiving a season pass upon number of ski days. If, instead, the researcher decide d to measure the subjects responses by asking them to check one of the se four replies on a survey, Much m ore often than last year, More often than last year, Just about the same as last ye ar, or Le ss often than last year, why would the inde pendent sample s t-test have to be abandoned for a Mann-Whitney U test instead? (Select all that apply.)

a. The variable of skiing is measured at the nominal instead of the ratio level. b. The variable of skiing is now measured at the ordinal instead of ratio level. c. The variable amount skied is now measured at the nominal level instead of the ratio level. d. The variable amount skied is now measured at the ordinal level instead of theratio level. e. Both variables levels have changed. f. The independent samples t-test used demands ratio-level or interval-level data. g. The Mann-Whitney U test allows for ordinal level values, but not nominal.

ANS: D, F, G The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test , paired or de pendent sample s t-test, and analysis of variance (ANOVA). If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonpar ametric analyse s of Mann-Whitney U, Wilcoxon signed-ranks test , and Kruskal-Wallis H are appropriate techniques to use to test the researchers hypotheses. If the data do not meet the assumptions involving normality and/or equal variance s for an independent sam ples t-te st, then the nonpar ametric alternative is the Mann-Whitney U test.

The Mann- Whitney U calculations involve converting the data to ranks, thereby discarding any variance or normality issue s associated with the original values. In some studie s, the dat a collected is ordinal level and the Mann-WhitneyU test is appropriate for analysis of the data.

DIF: Cognitive Level: Analysis REF: MCS: 580

6. Which of the following tests are parametric statistics that may be used to measure, clarify, or evaluate causation? (Select all that apply.)

a. t-test for independent samples b. Mann-Whitney U test c. t-test for dependent samples d. Wilcoxon signed-rank test e. ANOVA f. Tukey Honestly Significant Difference (HSD) g. Kruskal-Wallis test h. Chi-square ANS: A, C, E, F The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent sam ples t-test, and analysis of variance (ANOVA). In addition, the Tukey Hone stly Significant Difference test is a post hoc te st used to clarify which variable s are related, after an ANOVA shows a significant difference.

DIF: Cognitive Level: Analysis REF: MCS: 580

7. What are the principal reasons why any nonparametric test of causality was used instead of a parametric one? (Select all that apply.)

a. The assumptions for parametric analyses were not achieved. b. The effect that the interventional conditions produced was not measurable. c. The data were not normally distributed. d. The dependent variable was measured at the ordinal level. e. The results were not statistically significant.

ANS: A, C, D

If the assumptions for parametric analyse s are not achieved or if study data are at the ordinal level, then the nonparametric analyses of Mann-W hitney U, Wilcoxon signe d-ranks test, and Kruskal-Wallis H are appropriate techniques to use to test the researcher hypothese s. T-tests and ANOVA assume a normal distribution and measurement of the dependent variable at the interval/ratio level.

DIF: Cognitive Level: Analysis REF: MCS: 580

8. What do the t-test and the ANOVA have in common? (Select all that apply.) a. They are both used when the dependent variable is ordinal. b. They both assume a normal distribution. c. They both compare groups to decide if they are the same or different. d. They both can be used to compare two groups. e. They both require secondary post hoc analyses. f. They both use the same statistical tables for interpretation of results. g. They are both parametric analyses.

ANS: B, C, D, G The t-test and ANOVA are both par ametric analyse s; as such, they both assume a normal distribution and cannot be used when the dependent variable is ordinal. Both are used to compare groups, and both can actually be used when there are two groups, although for more than one only the ANOVA is used. If used with three or more categories, the ANOVA requires secondary post hoc analysis if its results are statistically significant. They use the t-test and F-test, respectively, and each has a separate table.

DIF: Cognitive Level: Application REF: MCS: 580

9. Which of the following results would represent statistical significance , if the level of significance were set at .05 for each? (Select all that apply.) a. t = 8.43, p <.01 b. X2 = 10.83, p <0.1

c. F = 2.37, p <0.07 d. r = 0.2, p = .23 e. rs = .74, p = .049 ANS: A, E The obtained result from the calculation of the statistic is compared with the appr opriate table, at the level of significance set by the researcher at the outset of the study. If that i s p < .05, it is essential that the correct value be retrieved from the table, for comparison. Re searchers often set the level of significance at .05. By that criterion, the two statistically significant values above are p <.01 and p = .049.

Chapter 26. Interpreting Research Outcomes MULTIPLE CHOICE

1. A researcher studies the effect on reading com prehension level of providing fourth-grade boys who are slow and ponderous readers with illustrated comic books for a six -week summer se ssion instead of textbooks, hypothe sizing that reading associated with pictures will result s in a higher reading com prehension level. The researcher set a level of significance at p <.05. Analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and composed of 100 subjects each. However, the experimental comic book groups scores improved less than did the scores of the boys who used the textbooks. The measured p-level was 0.026. What type of finding is this?

a. Significant results that are in keeping with those predicted by the researcher b. Nonsignificant results c. Significant results that oppose those predicted by the researcher d. Mixed results ANS: C Significant results opposite those predicted, if the results are valid, are an important addition to the body of knowledge. An example would be a study in which the researchers proposed that

social support and ego strength were positively related. If the study showe d that high social support was related to low ego strength, the result would be the opposite of that predicted. Such results, when verifie d by other studie s, indicate that the theory being tested needs modification and refinement. Because these types of studies can affect nursing practice, this information is important.

DIF: Cognitive Level: Application REF: MCS: 594

2. The analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and com posed of 100 subjects e ach. The instruments me asuring stress, mood, and various scaled measures of emotion were well normed, widely tested, and suitable . As the researcher begins interpretation of the data, she discovers that during data collection one of her assist ants had recorded the demographic item household size incorrectly, understanding the item as number of people who live with you. There is no way to determine which research assistant worked with which research subject.

What effect did this way of recording the data have on the study findings?

a. That item cannot be analyzed as a ratio item and will have to be treated in a different way.

b. None, because the numbers will be the same either way the data are collected. c. That particular item will have to be discarded, because it can no longer be analyzed. d. None, because post hoc statistical analysis will automatically adjust for this type of error.

ANS: A Many activities that occur during data collection affect the me aning of study result s. Did your study have a high refusal rate for subject participation, or was the attrition high? Was the sam ple size sufficient? Did strategies for acquiring a sample eliminate important groups whose dat a would have influence d the results?

Did you and your research team achieve intervention fidelity when the treatment was implemented? Did unfore seen events occur during the study that might have change d or had an impact on the dat a? Were measurement techniques consistent? What impact do inconsistencies have on interpreting results?

Methodological limitations result from fact ors such as nonrepresent ative samples, weak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of statistical analyses. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when dat a can be organized into categories of a define d property but the categories cannot be ordered. Data that can be measured at the ordinal level can be assigne d to categories of an attribute that can be ranked. In interval level of measurement, dist ances between intervals of the scale are numerically equal. Interval scale s are assumed to be a continuum of value s. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures.

DIF: Cognitive Level: Synthesis REF: MCS: 592

3. In a cross-sectional study, a researcher studies career trajectories in nurses over the past twenty years.

There are five correlational research hypothese s. Why are mixed results, related to significance of findings, to be expected?

a. The study is cross-sectional, and the economy has made bedside care a more practical decision over the past few years.

b. Groups acr oss time cannot be expected to have the same responses t o career advancement.

c. The study is merely correlational. d. Five st atistical hypothese s are being tested; not all of the se can be expected to demonstrate statistical significance.

ANS: D Mixed results are probably the most common outcome of studie s. In this case, one variable may uphold the characteristics predicted whereas another does not, or two depe ndent measures of the same variable m ay show opposite results.

DIF: Cognitive Level: Analysis REF: MCS: 594

4. A researcher working for a com pany that pr oduces a standardized exam that predicts whether or not nursing students will pass the national licensure exam tests this tool at a level of

significance of

= .01, with power = .91. The results are statistically significant. What

interpretation can the researcher justifiably make?

a. Findings are important to nursing schools, and valuable for them. b. The exam should be used by all nursing schools. c. There is good evidence that the results can be replicated, with similar results. d. Results will be the same if the study is repeated with another sample.

ANS: C The researcher choose s the probability of m aking a Type I error when setting , the le vel of significance.

Nursing rese archers usually set a level of significance of p <.05. A level of significance of p <.01 is much more stringent, and decreases the possibility of error to 1%.

Significant results that coincide with the researchers predictions are the easiest to explain and, unle ss weakne sse s are present , validate the propo sed logical links among the elements of the study. There is good evidence that the reports are reproducible.

DIF: Cognitive Level: Analysis REF: MCS: 594

5. Which of the following interpretations is acceptable as worded? a. The study proved that cigarette smoking causes lung cancer. Financial incentives must be offered by insurance companies to all persons who cease smoking.

b. Findings sugge st that antihypertensives influence both length and quality of life, and that their use is more beneficial than formerly realized.

c. The positive correlation between owning a dog who dem ands to be walked daily and the owners cardiovascular health indicates that all people should own dogs.

d. Results im ply that all humans who use amphetamine s will have shortened life spans, and patient teaching needs to include this vital information.

ANS: B Implications of research findings for nursing are the meanings of the conclusions for the body of nursing knowle dge, theory, and practice. Implications for practices are often based, in part, on whether treatment decisions or outcomes would be different in view of the study findings. The

study implications pr ovide specific suggestions for implementing the findings in practice. Even when the results are significant and in keeping with those predicted by the researcher, the researcher must consider alternative explanations for the positive findings and cannot use the word should or its synonyms. One study does not prove that sm oking causes lung cancer. A correlational study merely provide s evidence of association.

DIF: Cognitive Level: Analysis REF: MCS: 599

6. A researcher studies the effect upon pain control of providing pet therapy for children on a pediatric ward.

While conducting the study, the rese archer become s aware of a strong correlation between parental presence and hours of childrens sleep. What is this correlation?

a. The ability to consent far more subjects than were originally projected: a lucky occurrence b. A relationship between variable s that were not hypothe sized or predicted from the framework: serendipitous finding

c. The identification of a variable that affects the de pendent variable and dist orts its value: extraneous variable

d. A condition that affects generalization: limitation ANS: B Serendipitous result s are relationships found between variable s that were not hypothesize d and not predicted from the framework guiding the study. These unexpected results are also called serendipitous result s. Most researchers examine as many elements of data as possible in addition to those directed by the research objectives, que stions, or hypothe ses. They can use these findings t o de velop or refine theories and to formulate later studies. In addition, serendipitous results are as important as evidence in developing the implications of the study. However, rese archers must deal carefully with serendipitous result s when considering their meaning, because the study was not designed to examine these results.

DIF: Cognitive Level: Analysis REF: MCS: 595

7. A researcher summarizes the findings and then make s generalizations. Why does the researcher refer to the literature before making generalizations?

a. If the current study is a replication of previous rese arch, it s generalizations will be identical to those of the study it replicates.

b. If there is no previous research in this area, no generalizations can be made. c. If the current study is the second by this researcher, it s generalizations will be to the population fr om which the second sample was drawn, and will specifically exclude the sample from the first study.

d. If there is a lone study in this area, gener alizations are narrow; if there is previous rese arch of a parallel nature, more widespread generalization is in order.

ANS: D Generalization extends the implications of the findings from the sample studied to a larger population or from the situation studied to a larger situation. If there is previous identical or very similar research in this area, generalizations can be made to the populations from which this and other studies were drawn, thus increasing generalizability. Generalizations based on accumulated evidence from m any studies are calle d empirical generalizations. These generalizations are important for verifying theoretical statements or developing new theories. Empirical generalizations are the base of a science and contribute to scientific conceptualization, which provide a basis for generating evidence-based guidelines to manage specific practice problems.

DIF: Cognitive Level: Analysis REF: MCS: 598

8. Near the end of a rese arch article, the researcher state s that the findings contribute to nursings body of knowle dge and they also provide e vidence that the intervention m ay be helpful in the population from which the sample was drawn. What does this comment address?

a. Serendipitous findings b. Implications c. Generalizations d. Limitations ANS: B Implications are the meanings of conclusions for the body of knowledge, the ory, and pr actice. Implications are based on the conclusions and are more specific than conclusions. They provide

specific sugge stions for implementing the findings. Ge neralization extends the implications of the findings from the sam ple studied to a larger population or from the situation studied to a larger situation.

Serendipitous findings are relationships found between variables that were not hypothe sized and not predicted from the framework guiding the study. Limitations are restrictions or problems in a study that may decrease the generalizability of the findings.

DIF: Cognitive Level: Application REF: MCS: 598 MULTIPLE RESPONSE

1. The analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and compose d of 100 subjects each. The instruments me asuring stress, m ood, and various scaled measures of emotion were well normed, widely tested, and suit able. As the researcher begins interpretation of the data, she discovers that during data collection one of her assist ants had recorded the demographic item household size incorrectly, underst anding the item as number of people who live with you. The original paper surveys are still available , and the ones this particular assist ant collected are all clearly marked with her initial on each MCS:. How can this data item be saved? (Select all that apply.)

a. Erroneous values can be identified and eliminated from the data analysis for thissingle item. b. Erroneous values can be located and re-entered as the true values, since the systematic error has been identified, quantified, and attributed.

c. Data analysis m ay proceed and the error noted in the final report as a methodological limitation.

d. An overlapping ordinal me asurement can be used, in which the categories are 0-1, 1-2, 2-3, and so forth.

e. The data may be analyzed as a nominal variable and so coded.

ANS: A, B Many activities that occur during data collection affect the meaning of study re sults. Methodological limitations result from factors such as nonreprese ntative sample s, we ak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of

statistical analyses. Nominal level of me asurement is the lowe st of the four measurement levels or categories.

It is used when dat a can be organized int o categories of a de fined pr operty but the categories cannot be ordered. Data that can be measured at the ordinal level can be assigned t o categories of an attribute that can be ranked. In interval le vel of measurement, distances between intervals of the scale are numerically equal.

Interval scales are assume d to be a continuum of values. Ratio level of measurement is the highest form of measure and meets all t he rules of the lower forms of me asures. To be me aningful, me asurements must be mutually exclusive.

Changing the data to a nominal or ordinal measurement will not save the item. Reporting the item as erroneous does not save the item.

DIF: Cognitive Level: Synthesis REF: MCS: 592

2. A researcher has conducted a study that use s a measurement tool for agitation, normed in a hospital setting, in an out patient mental health setting. After completion of the dat a analysis phase , which of the following is the next logical step in evaluating the evidence?

a. Recalibration of all instruments used for physiologic measurements b. Review of the literature c. Identification of statistically significant findings d. Examination of the measurement tools reliability in this setting e. Re-evaluation of the tools validity in this population ANS: D, E One assumption often m ade in interpreting study results is that the study variables were adequately measured. This adequacy is determined by examining the fit of operational de finitions with the framework and through validity and reliability information. Although reliability and validity of measurement strategies are reviewed before use, one must reexamine the measures at this point to determine the strength of evidence available from the results. For example, did the measurement truly reflect the concept in the study population? Were the validity and reliability of instruments examined in the pre sent study? The validity and reliabilityof measurement methods are critical to the validity of results.

DIF: Cognitive Level: Application REF: MCS: 591

3. A researcher studie s the effect of a com puterized hospital charting system on nur ses compliance with charting the exact times of tracheostomy care, periodic turning of patients, and bed baths. The researcher hypothe sizes t hat instituting the new charting system would improve compliance. The sample size is 120. The level of significance is set at .05 and the power at 80%. Findings are nonsignificant, at p = .146. How might this be discussed by the researcher? (Select all that apply.)

a. The null hypothesis was accepted. There was no difference in compliance when paper charting was replaced with computer charting, in terms of the variables of trache ostom y care, periodic turning, and bed bath charting.

b. Nurses do not chart consistently the tracheostomy care, periodic turning, and bed baths they deliver, regardless of charting system.

c. The effect size was smaller than expected; a repeat power analysis reve aled that the sample size of 120 was insufficient to demonstrate a significant difference.

d. This study showed no significant difference between the two charting methods, in terms of compliance.

e. Had the level of significance been set at 0.15, the findings would have reached statistical significance.

ANS: A, C, D, E Unpredicted nonsignificant or inconclusive result s are the most difficult to explain. These result s are often referred to as negative results. The negative results could be a true reflection of reality. In this case, the reasoning of the researcher or the theory used by the researcher to develop the hypothesis is in error. If so, the negative findings are an important addition t o the body of knowle dge. With nonsignificant results, it is important to determine if ade quate power of 0.8 or higher was achieved for the data analysis. Thus, the researcher needs t o conduct a power analysis t o determine if the sam ple size was adequate to prevent the risk of a type II error. A type II error means that in reality the findings are significant, but , because of we akne sse s in the methodology, the significance was not detected. Negative results, in any case, do not mean that there are no relationships among the variables or differences between groups; they indicate that the study failed to find any.

DIF: Cognitive Level: Application REF: MCS: 594

4. A nurse manager in a trauma intensive care unit conducts a quality improvement evaluation pr oject.

During this process, she discovers that patients with adult respirat ory distress syndrome alm ost always have better outcomes when they are placed in the five beds located further away from the nursing st ation.

Examining the data, she discover s that the room doors in these five rooms are consistently half-closed or three-quarters closed. In addition, nurse s have been documenting that these patients sleep m ore than the other ten patients on the unit. What are the nurses options for generalizing the findings?

a. There is no practical use for this research; no generalization is appropriate. b. Findings should be generalized immediately, and in print. These are important findings. c. The nurse can present the findings at conferences, but ge neralization is limited t o the hospital in which the data were collected.

d. The nurse m anager can obt ain permission from an institutional review board to conduct a formal rese arch study, in order to form ally test hypothe ses, and the n generalize the findings of this second study.

e. Arrangements should be made immediately on the unit to keep all patients door s half-close d or three-quarters closed.

ANS: C, D Methodological limitations limit the credibility of the findings and restrict the population to which the findings can be generalized. Methodological limitations result from factor s such as nonrepresentative samples, we ak de signs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over dat a collection, and im proper use of statistical analyses. Quality improvement research, by definition, is methodologically limited, because of its location-specific findings and lack of controls.

DIF: Cognitive Level: Analysis REF: MCS: 594

5. If, after power analysis, a researchers interventional study findings are nonsignificant, what might this imply? (Select all that apply.)

a. The effect size was smaller than originally expected.

b. The effect size was larger than originally expected. c. The operational definition of the independent variable was faulty. d. The operational definition of the dependent variable was faulty. e. A type I error occurred. f. A type II error occurred. g. The intervention is not an effective one.

ANS: A, C, D, F, G Negative results could be due t o inappropriate methodology, a deviant sample , problems with internal validity, inadequate measurement, poor variable definition, the use of weak st atistical techniques, or faulty analysis. Negative results, in any case, do not me an that there are no relationships among the variables or differences between groups; they indicate that the study failed to find any. The sam ple size was initially judged to have been adequate enough t o prevent the risk of a type II error, base d on initial calculations, but if the effect size was very sm all, a type II error might have occurred. The negative results could be a true reflection of reality. In this case , the reasoning of the researcher or the theory used by the researcher to develop the hypothesis is in error.

DIF: Cognitive Level: Evaluation REF: MCS: 594

6. How are marke dly negative results of a multi-site interventional nur sing study with a huge sam ple and stringent level of significance helpful?

a. They rule out the usefulness of the intervention for all clients. b. They provide evidence that may change clinical practice, if the intervention is currently being applied in practice to all health care clients.

c. They contribute to the total body of nursing knowledge. d. They may indicate different directions for theoretical ideas. e. They establish the fact that the intervention is not universally effective with allclients. f. They allow only cautious generalization.

ANS: B, C, D, E

The negative result s could be a true reflection of re ality. In this case, the reasoni ng of the rese archer or the theory used by the researcher to develop the hypothesis is in error. Since this was a huge multi-site interventional study, it est ablishes the fact that the intervention does not work with a sizable number of clients. This is useful to know.

DIF: Cognitive Level: Application REF: MCS: 594

7. In interpreting the findings of a study, the researcher should do which of the following? (Select all that apply.)

a. Discuss the findings, with respect to clinical implications. b. Boldly and fearlessly identify the limitations of the study. c. Make cautious and well-founded conclusions, based on the findings. d. Based on the existing literature, plus this study, recommend further research. e. Make excuses for limitations. f. Relate findings back to the purpose and framework of the study. g. Generalize broadly.

ANS: A, B, C, D, F Interpretation includes several intellectual activities, such as examining e vidence, forming conclusions, identifying study limitations, generalizing the findings, considering implications, and suggesting further research. Generalizations should be specific to the population from which the sample was dr awn, and should be based on the total contribution of research, to date. Excuses should not be made.

DIF: Cognitive Level: Analysis REF: MCS: 600

8. A researcher has just completed a study demonstrating the e ffectivene ss of three daily servings of freshly pressed tom ato juice for prevention of cancers of the gastrointestinal tract. The results were statistically significant at the p <.01 level. During interpretation, which of the following will the researcher employ? (Select all that apply.)

a. Examination of the results, in comparison with similar literature about fresh tomatoe s and cancer, to decide whether the sum of all knowledge constitutes sufficient evidence for widespread generalization

b. Exploration of the clinical significance of the findings, as opposed to the statistical significance

c. Initiation of discussions with m anufacturers of juice machines, so as to t ake advant age of the anticipated increase in sales

d. Formation of some sort of conclusions, relative to the study findings and relatedliterature e. Promulgation of the results to the popular media, so that as many pe ople as possible in the world can advantage themselves of the intervention

f. Recommendations for further studies on fresh t omato juice and its apparent effects on health

g. Consideration of implications related to nursings body of knowledge ANS: A, B, D, F, G The process of interpreting research outcomes for quantitative , outcome s, and intervention studies includes the following: (1) examining study evidence, (2) determining findings, (3) forming conclusions, (4) identifying limitations, (5) generalizing the findings, (6) considering implications for practice, and (7) suggesting further studies.

DIF: Cognitive Level: Application REF: MCS: 590

9. The United States census is an example of a huge descriptive research project that uses the entire population as the sam ple. What are some of the limitations of generalizing census findings back to the entire population? (Select all that apply.)

a. Although all homes must fill out a census report, the homeless population often cannot be accessed, surveyed, and counted, so the homeless population is underrepresented in the findings.

b. Persons whose primary language is something other than English or Spanish, and who do not speak either language, are more likely to be missed in the census.

c. The survey method of data collection relies on self-report; some misrepresentation or error is inevitable.

d. The population changes continuously, and the one describe d in the census isnt very much like the population on the day the results are published.

e. Persons in the United States who are no longer here legally but plan to st ay do not fill out a report.

ANS: A, B, C, E Limitations are restrictions or problems in a study that may decrease the generalizability of the findings. All studies have limitations, and these might be theoretical and/or methodological in nature. Theoretical limitations are weaknesses in a study framework and conceptual and operational definitions of variable s that restrict the abstract generalization of the findings.

Methodological limitations are factors in the study de sign that can limit the credibility of the findings and restrict the population to which the findings can be generalized.

DIF: Cognitive Level: Analysis REF: MCS: 598

10. Choose which of the following limitations are methodological, in a study of home UV treatment of depressive illnesses. (Select all that apply.)

a. A study performed in Afghanistan is published only in a British journal. b. The operational definitions are not in line with the conceptual definitions. c. The study framework is related to the social costs of depressive illness. d. The subjects excluded from participation in a study of depressive illness and UV home treatment were those who had been hospitalized in the past for depression.

e. A multi-site study examining UV home treatment and depressive illness is conducted only in major west coast urban centers.

ANS: A, B, D, E Limitations are restrictions or problems in a study that may decrease the generalizability of the findings. All studies have limitations, and these might be theoretical and/or methodological in nature. Theoretical limitations are weaknesses in a study framework and conceptual and operational definitions of variable s that restrict the abstract generalization of the findings.

Methodological limitations are factors in the study de sign that can limit the credibility of the findings and restrict the population to which the findings can be generalized. Studies can be

generalized to the population fr om which the sam ple was drawn; a sample drawn from one geographic area can, in general, be generalized back only t o that are a. The findings from a study conducted in Afghanistan (and published in English in a British journal) can be generalize d back to Afghanist an. Studie s conducted in one language and published in another may be flawed in other ways.

Chapter 27. Disseminating Research Findings MULTIPLE CHOICE

1. A masters student st ates, in her thesis, that despite public awarene ss program s to educate the public about the safety of pediatric immunizations, a st aunch core of highly educated and well - informed parents continues to attribute the rise in childhood autism to vaccination. Because of this, recent efforts have been brought to bear in the qualitative arena, attempting to identify and isolate factoids and half-truths that perpetuate the myth. Nonetheless, mostly because belief structures appear bound by geography, not enough is known about reasons that some clusters of parents postpone or avoid vaccination. The quotation is an example of a

and appears in the

section of

the research report.

a. Objective, methods b. Purpose statement, introduction c. Problem statement, introduction d. Literature review, results ANS: C The problem st atement identifies the specific gap in the knowledge needed for practice. The introduction of a research report discusse s the backgr ound and significance of the problem ; identifies the problem statement and purpose, reviews the relevant empirical and theoretical literature, describes the study framework, and identifies the research purpose (aims, objectives, questions, or hypotheses if applicable).

DIF: Cognitive Level: Application REF: MCS: 604

2. Prior to conducting a grounde d theory study, in which eleven women undergoing radiation for breast cancer were interviewed multiple times, the researchers conducted a pilot study in which they interviewed three women every two weeks from the time radiation was planned until four weeks after it was completed.

The purpose for the pilot study was t o refine the interview instrument and to discover whether women would be willing to be interviewed this frequently about such a private topic. The pilot was not publishe d se parately, and the researcher wants to include information about revisions in the instrument during the pilot phase .

Where would this be included in the research report?

a. Introduction b. Methods c. Results d. Appendix ANS: B If the research project included a pilot study, in the methods section the researcher will briefly describe the planning, implementation, and results obtained from the pilot study. Any changes made in the research project based on the pilot study are mentioned here.

DIF: Cognitive Level: Application REF: MCS: 605

3. Prior to conducting a grounded theory, in which ele ven women undergoing radiation for bre ast cancer were interviewed multiple times, the rese archers conducted a pilot study in which the y interviewed three women every two weeks from the time radiation was planned until four weeks after it was completed. The purpose for the pilot study was to refine the interview instrument and to discover whether women would be willing to be interviewed this frequently about such a private topic. The pilot was not publishe d se par ately, and the institutional review board application indicated the rese archers intent to include information in the research report about what going through the process of r adiation therapy was like for the three pilot study women, in addition to the eleven main study women. In this case, if it were not included in the method section, where would the inform ation about the process of going through radiation therapy obtained from the pilot study women be included?

a. Introduction b. Results c. Discussion d. Appendix ANS: B If the research pr oject included a pilot study, in the methods section the researcher will briefly de scribe the planning, implementation, and result s obt ained fr om the pilot study. Any changes made in the research project base d on the pilot study are mentioned here. However, data analysis in qualit ative research occur s concurrently with data collection. In addition, analysis of an interviews data m ay result in additional que stions being asked in subsequent interviews to confirm or not confirm initial interpretations of the data. Because of this, information related to the phenomenon and obtained in the pilot phase m ay be included in the result s section.

DIF: Cognitive Level: Application REF: MCS: 605

4. All subjects were asked whether they would be willing to participate in this descriptive study, while they waited to be seen by a gastroenterologist , prior to their initial colonoscopies. They were given basic information about the research and told that participation was strictly voluntary, according to guidelines from the institutional review board (IRB) for the clinics and hospital. The re search had been appr oved as minimal risk by the IRB. All thirty-one subject s asked to participate agreed to do so. During the write-up of the study, the researcher should include this information about this process in which of the following sections?

a. Abstract b. Introduction c. Methods d. Appendix ANS: C

The data collection process was clear and concise ; IRB approval was indicated; subjects informed consent was described; use of trained data collectors was addressed; and timing and setting was discussed.

DIF: Cognitive Level: Application REF: MCS: 607

5. Lazaruss coping paradigm suggests that it is the appraisal of a stressor as potentially harmful that begins the avoidance cascade. Thomason further char acterized adapt ations to management of chemotherapy symptom atology as mere reflections of a primary appr aisal of potential harm, providing a set point for intensity of reactions. We used these c onceptual connections to formulate test able assumptions for this study. Where in the research report would this quotation be located?

a. Introduction b. Methods c. Results d. Discussion ANS: A The introduction of a research report discusse s the background and significance of the problem, identifie s the problem statement and purpose , reviews the relevant empirical and theoretical literature, describes the study fr amework, and identifies the research purpose (aims, objectives, questions, or hypothese s if applicable).

DIF: Cognitive Level: Application REF: MCS: 604

6. Thomasons set-point theorizations explain, in part, why patient s in chemotherapy who reported high levels of apprehension and anxiety prior to initiation invariably reported more severe average symptom atology levels. In addition, their symptoms were ameliorated less completely by standard therapeutic interventions, such as antiemetics and soporifics. Where in the research report would this quotation be located?

a. Introduction

b. Methods c. Results d. Discussion ANS: D In the discussion section, the researchers major findings, which are generated through an interpretation of the result s, should be discusse d in relation to the overriding conceptual framework as well as the research problem, purpose, and questions, or hypotheses.

DIF: Cognitive Level: Application REF: MCS: 630

7. What part of the research report names the study design? a. Introduction b. Methods c. Results d. Discussion ANS: B In the methods section the researcher describe s the study de sign, sample, setting, methods of measurement, data collection process, and plan for data analysis.

DIF: Cognitive Level: Comprehension REF: MCS: 605

8. The results of an applied rese arch study for anxiety management in children were published in both a highly respected nursing research journal and a second journal specific to pediatrics that focuse d on practice issue s.

The first article contained detailed statistical analyse s and discussions of the results, as an extension of the authors previous basic research. The second presented the research in much simpler language, providing pictures of the children and discussing practice applications. Why does this represent or not represent duplicate publication?

a. It does represent duplicate publication, because both articles reported results of the same study.

b. It does not represent duplicate publication, because the language was completely different in the two articles, and the journal audience was different.

c. It does represent duplicate publication, because the second article was a paraphrase of the first.

d. It does not represent duplicate publication, because the second article referenced the first and focused heavily on practice applications, which were not included in the first.

ANS: D Duplicate publication is the pr actice of publishing the same article or m ajor portions of the article in two or more print or electronic media without notifying the editors or referencing the other publication in the reference list.

DIF: Cognitive Level: Analysis REF: MCS: 632

9. In the results section of a thesis measuring the e ffectivene ss on a geriatric ward of using a procedure room for all painful procedures including IV starts, a masters student lists the four principal study findings, one by one, following each with an explanation of how e ach finding contributes to nursing knowledge . The major thesis advisor directs the student to fix this in the second draft of the thesis. Why does the thesis advisor require this?

a. This entire segment of the thesis should appe ar in the discussion section. The results section contains all of the study findings, with detailed statistics on each.

b. A thesis should not explain how its findings contribute to nursing knowledge. c. This is applied research. Its findings should apply only to practice. d. Findings appear in the results section, which includes only facts and nothing else . The explanation part of the above must be placed in the discussion section.

ANS: A The discussion section includes conclusions, study limitations, implications for nursing, and recommendations for further research. Implications of the findings for nursing practice and theory development are explored, and suggestions are provided for further research.

DIF: Cognitive Level: Application REF: MCS: 618

MULTIPLE RESPONSE

1. In which parts of the research report could the reader find the one most important result of the study?

(Select all that apply.)

a. Abstract b. Introduction c. Methods d. Table 1 e. Results f. Discussion g. References h. Appendix ANS: A, E, F An abstract is usually about 200 t o 300 words and describe s the problem , purpose, framewor k, methods, sample size, key results, and conclusions. The results section reveals what was learned from the study and includes the results generated from the studys st atistical analyses. The discussion section include s the studys major findings, limitations, conclusions, implications, and recommendations for further research.

DIF: Cognitive Level: Synthesis REF: MCS: 603

2. There was a re search gap be fore the study was performed. The rese arch filled t he research gap. In what part of the rese arch report would the research gap be identified? In what part of the research report would the researchers way of filling the research gap be reported? (Select all that apply.)

a. Abstract References b. Abstract Abstract c. Introduction Discussion d. Introduction Methods

e. Abstract Methods f. Methods Methods g. Results Discussion h. Introduction Discussion ANS: D, E An abstract is usually about 200 to 300 wor ds and describe s the pr oblem, purpose, framework, methods, sample size, key results, and conclusions. In describing the problem and purpose, it strongly implie s the gap.

The introduction of a research report discusse s the background and significance of the problem , identifie s the problem statement and purpose, reviews the relevant empirical and theoretical literature, describes the study framework, and ide ntifies the rese arch purpose. The summary of the literature review clearly identifies what is known, what is not known or the gap in knowledge, and the contribution of this study to the current knowledge base. The methods section of a research report describes how the study was conducted.

DIF: Cognitive Level: Synthesis REF: MCS: 605

3. What part of the research report may provide potential applications of the findings in practice? (Select all that apply.)

a. Abstract b. Introduction c. Methods d. Results e. Discussion ANS: A, E An abstract is usually about 200 to 300 words and describe s the pr oblem, purpose, framework, methods, sample size, key results, and conclusions. Conclusions can include potential applications for practice. The discussion section ties the other sections of the research report together, and includes major findings, limitations of the study, conclusions dr awn from the findings, implications of the findings for nur sing, and recommendations for further research.

DIF: Cognitive Level: Synthesis REF: MCS: 603

4. A masters the sis uses Husserlian phenomenology as it s method. In the research report, the student has mentioned the method by name and has adhered to all of the tenets of that method. The thesis advisor requires the student to include in the thesis a two- to five-MCS: summ ary of the philosophy of Husserlian phenomenology. Why does the thesis advisor require this? (Select all that apply.)

a. The thesis advisor is not familiar with the method and cannot evaluate the thesis without this information.

b. It is important that the the sis m ake s clear what Husserlian phenomenology implies, relative to the researchers part in data collection and data analysis.

c. Several assum ptions of the thesis m ay emanate fr om Husserlian phenomenology, and they should be consistent with its philosophy.

d. The reader of the thesis, and publications emanating from it, may not be cle ar as to what Husserlian phenomenology is. An explanation is in order.

e. The reader can follow the analysis better when the method is better understood. f. The philosophy that underlies qualitative research is, in essence, the studys theoretical framework. A framework should include a summary of its main points.

ANS: B, C, D, E, F The philosophical perspective of the rese archer guide s the questions asked and the methods selected for conducting a specific study. Both quantitative and qualitative researchers have philosophical perspectives.

Qualitative studie s are based on a wide range of philosophies, such as phe nomenology, symbolic interactionism, constructivism, and hermeneutics, e ach of which espouses slightly different approache s t o gaining new knowledge. Most qualitative rese archers do not identify specific theoretical frameworks during the design of their studies, as is expected for quantitative studies. Instead, the philosophical basis pr ovide s theoretical grounding for qualit ative studie s without predisposing the dat a analysis to a single interpretationthis is another way to say that the philosophy is the studys theoretical framework. As such, it deserves a few MCS: of exposition, to aid the readers understanding.

DIF: Cognitive Level: Synthesis REF: MCS: 616

5. A researcher present s the results of a recent research project at se veral conferences. Duplicate publications are not accept able and repre sent self-plagiarism, but duplicate prese ntations seem value d.

Which of the following facts explains this? (Select all that apply.)

a. Duplicate conference presentations are valued only when they occur in widely separated geographic areas.

b. Questions and comment s from conference audiences can contribute to the researchers ongoing analysis and inspire new analyses of data.

c. If similar rese arch by the same author is ongoing, each conference presentation can include new insights and interpretations, reflecting work in progress.

d. Reaching a broad audience necessitates presentation at several conferences. e. Self-plagiarism is a term that refers to the printed word, not to conference presentations.

f. If a researcher submit s a different abstract to each conference that publishe s printed conference abstracts, there is no self-plagiarism.

ANS: B, C, D, E, F Duplicate publication is the practice of publishing the same article or major portions of the article in two or more print or electronic media without notifying the editors or referencing the other publication in the reference list. Duplicate publication does not refer to oral presentations. However, if portions of an article have been presented at a scientific meeting in the form of an oral podium or poster presentation, this should be acknowledged along with funding sources and any potential conflict of interest.

DIF: Cognitive Level: Analysis REF: MCS: 632

6. Which of the following are considered poor scholarly writing and, conse quently, should not appe ar in a published research report? (Select all that apply.)

a. Subjects who could not decide whether to select A, B, or C as item options were instructed to leave the item blank.

b. Regardless of am ount of the independent variable of electricity that was applied, dependent variable changes were negligible thus indicating lack of causation.

c. Any subject desiring to retract their permission for the study had his or her name removed from the master list.

d. Erstwhile subjects had little insight into the retained fragments of their sublimated ignoscency.

ANS: B, C, D A quality re search report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations. Word processing pr ogram s have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629

7. Which of the following additional items are considered poor scholarly writing and, consequently, should not appear in a published research report? (Select all that apply.)

a. Subjects A and B com pleted the trial in half the time taken by other subjects, without caffeine enhancement. Hah!

b. Subject attrition was nil. Not one per son dropped out of the study, even in progre ss.

Except the ones we kicked out, of course.

c. Subjects responses were markedly different across groups. d. The intervention group was expected to document symptom s at least daily, using a journal.

Twice-daily documentation was encouraged.

e. Instruments were calibr ated, both be fore, and after, use: they were cleaned, as well; using soap and water.

ANS: A, B, C, E A quality re search report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations. Word processing pr ogram s have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629

8. Which of the following represent poor scholarly writing and, consequently, should not appe ar as they are written in a journal article? (Select all that apply.)

a. Regretfully nobody in the control group survived past three years this is because of the continued effects of the disease process itself if untreated it is fatal.

b. Results of the study indicated that causation was directional in the A, B, F, and K groups however none were identified as impacting the final outcome.

c. We as experienced researchers cannot explain why the intervention failed in not one, but three consecutive mini-trails, num bers 5, 6, and 7, becoming suddenly e ffective in the subsequent twenty-three mini-trials. We checked and rechecked instrument calibrations, controlled diligently for intra-rater reliability, recom puted coe fficient s of change, trended all data, reentered data manually, examined the effect of sixteen potentially extraneous variables, and ultimately ended as baffled as we started.

d. The results were a complete surprise. 44% of the control subject s experienced spontaneous remissions.

e. Attrition continued over the course of the experiment, with additive attrition of 2% in the first quarter, 5% in the second quarter, 16% in the third quarter, and 25% in the fourth. In the second year, attrition claimed another half of the sample. Dat a collection was suspende d after the eighth quarter, since the results had limited applicability, due to extensive attrition.

f. An inadequate sample thre atened to e nd the study. Inclusion criteria were broadened, to include those who had participated in clinical research, in the past, but there were no takers.

g. There was no way of determining whos answers had been positive on the pre -test, until the post-test was completed.

ANS: A, B, C, D, F, G A quality re search report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations. Word proce ssing program s have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629

9. There are several steps in the process of converting a masters thesis into a publishable article: selecting a journal, writing a query letter, preparing an original manuscript, submitting the manuscript for review, and performing the revisions the editor indicates. Why should prepar ation of the manuscript not occur fir st? (Select all that apply.)

a. It would be foolish to write a manuscript without knowing the maximum length of manuscript that a journal accepts.

b. If the response to several query letters is negative, it is be st to abandon attempts to get the information into print.

c. Various journals use different formatting. Waiting until editor interest is expressed saves unneeded reformatting.

d. Some journals limit the number of items in the reference list. It is best to know this before editing the thesis down to the length of an article.

e. Every contact with an editor result s in at least a reque st for revisions. An initial manuscript cannot be prepared without editor input.

ANS: A, C, D Developing a m anuscript for publication include s the following steps: (1) selecting a journal, (2) developing a query letter, (3) preparing a manuscript, (4) submitting the manuscript for review, and (5) revising the manuscript . A query letter should be no more than one MCS: and usually includes the abstract as well as the researchers qualifications for writing the article. I f the response to the query letter is possible, then a manuscript should be prepared, according to the form atting and specifications of that publication. A negative response to a query letter merely implies that the journal is not interested in the topic of the submitted abstract.

DIF: Cognitive Level: Comprehension REF: MCS: 628

10. What should an abstract for quantitative research contain? (Select all that apply.) a. The name of the research method used b. A brief statement of the problem c. The research purpose d. The population or sample e. The major study findings f. Conclusions g. The research hypothesis h. The research question

ANS: A, B, C, D, E, F Most rese arch reports include an abstract that summarizes of the key aspects of the study. An abstract is a terse summary, often between 200 and 300 words, that de scribes the problem, purpose, framewor k, methods, sample size, key results, and conclusions.

DIF: Cognitive Level: Application REF: MCS: 603

11. What else should an abstract for quantitative research contain? (Select all that apply.) a. The research question b. Operationalized variables c. The research hypothesis d. The major study findings e. Conclusions f. References ANS: D, E Most rese arch reports include an abstract that summarizes of the key aspects of the study. An abstract is a terse summary, often between 200 and 300 words, that de scribes the problem, purpose, framewor k, methods, sample size, key results, and conclusions.

DIF: Cognitive Level: Application REF: MCS: 603

12. What are the proper components of a query letter? (Select all that apply.) a. Suggestions for further research b. A description of the research problem c. The sample demographics d. Discussion of one or more of the major findings e. Academic or professional titles held by the letter writer f. Details of the study methodology g. The meaning of the study findings

ANS: B, D, E, G A query letter is developed to determine an editors interest in reviewing a manuscript for publication. A query letter should be no m ore than one MCS: and usually includes the abstr act, as well as the researchers qualifications for writing the article.

DIF: Cognitive Level: Comprehension REF: MCS: 628

13. A researcher who has just submitted a trimmed-down ver sion of her doctoral dissertation to a journal editor receives the following. What type of letter is it? (Select all that apply.)

Dear Ms. Smith: We have received your manuscript and are returning it to you. Our journals focus is exclusively quantitative research, and your manuscript use s a mixed methodology. Despite not able strengths of the quantitative portion, which contains cutting-edge information about medication errors and their correlates, our peer reviewers feel that you might be better served in seeking a venue that allowed both aspect s of the study to be presented. The Nursing Journal of Mixed Methodologies springs to mind.

Nonetheless, if you should wish to resubmit only the quantitative portion, e ssentially as it st and s, we should be quite interested in returning it to the peer reviewers.

Please see the one accompanying suggestion for table insertion.

a. An outright rejection b. An acceptance c. An acceptance with minor revisions d. A rejection of the manuscript as currently written e. A suggestion for an alternative avenue of publication f. A

compliment

ANS: C, D, E, F

After reviewing a manuscript, the journal editor will reach one of four possible decisions: (1) acce ptance of the manuscript as submitted, (2) acceptance of the manuscript pending minor revisions, (3) tentative acceptance of the manuscript pending major revisions, or (4) rejection of the manuscript. Accepting a manuscript as submitted is extremely rare. At the end of the revision process, the editor will send the author a letter that indicates final acceptance and the likely date of publication.

DIF: Cognitive Level: Analysis REF: MCS: 630

14. What are the advant ages of presenting a poster session, displayed for two hour s a day for three days at a well-attended conference, instead of a 15-minute verbal presentation with a 5- minute que stion period, at a breakout session? (Select all that apply.)

a. For author s who suffer presentation anxiety, a poster presentation can be much less stressful, since it provides many small conversations instead of a large lecture.

b. A poster session allows the researcher to display more inform ation than a verbal presenter can.

c. A poster presentation provides the opportunity for one-to-one interaction with the viewers. d. The poster presentation may reach more people than does the verbal presentation. e. A verbal presentation requires more time to develop than does a poster.

ANS: A, C, D Research findings are communicated at conferences and meetings thr ough verbal and poster present ations.

With presentations, rese archers have an opportunity to share their preliminary findings, answer questions about their studies, interact with other interested researchers, and receive immediate feedback on their study. A 15-minute verbal pre sentation would consist of a 15-slide show (PowerPoint or otherwise). A poster session is a visual presentation of your study, all on one surface , with either three or four columns. Posters usually take from 10 to 20 hours to develop based on the com plexity of the study and the experience of the researcher. Novice researchers usually need more than 20 hours to de velop a poster. One m ajor advant age of a poster session is the opportunity for one-to-one interaction between the researcher and the

viewer. At the end of the poster session, individuals interested in a study will frequently stay to speak to the researcher. A quality poster is easily comprehended in 5 minutes or less.

DIF: Cognitive Level: Analysis REF: MCS: 630

15. A journal states on its editorial MCS:, A query letter is required before article submission to this refereed journal. I f a manuscript is requested, both hard copy and an electronic copy will be required. After initial acknowledgement of receipt, authors will receive a response from the editor within four months. What does this statement mean? (Select all that apply.)

a. Within four months, the author will be notified whether the article is accepted. b. The author will be notified immediately of the manuscripts acceptance. c. Only the editor reviews manuscripts. d. The journal uses peer review. e. If authors send a manuscript without an initial query, it will be returned. f. If authors send a query letter, they will be requested to send a manuscript. g. If a manuscript is accepted, it will be published within four months. h. No manuscripts are ever accepted.

ANS: A, D, E A query letter is developed to determine an editors interest in reviewing a manuscript for publication. A query letter should be no more than one MCS: and usually include s the abstract as well as the researchers qualifications for writing the article. Journals that require a query letter will not accept manuscript s without that initial query. A refereed journal is peer-reviewed and uses referees or expert reviewers to determine whether a manuscript is acce ptable for publication. Most refereed journals require manuscript s to be reviewed anonymously, or blinded, by two or three reviewers. Most academic institutions support the refereed system and may only recognize publications that appe ar in peer reviewed journals for faculty see king tenure and promotion.

DIF: Cognitive Level: Comprehension REF: MCS: 629

16. A masters student has just com pleted a the sis. Which of the following are considered dissemination of the results? (Select all that apply.)

a. Interactions with the thesis committeethrough reading the thesis, they have been informed of the results

b. Presentation of a poster session at a professional conference c. Presentation of an oral (podium) presentation at a professional conference d. Presentation of a guest lecture about the thesis results at a university e. Having an article about the research results published by a journal f. Having an article about the research results published by a popular magazine ANS: B, C, D, E, F Communicating research findings, the final step in the research process, after completion of the thesis, involve s developing a rese arch report and disseminating it through presentations and publications to audiences of nurses, health care professionals, policy makers, and health care consumers.

Chapter 28. Writing Research Proposals MULTIPLE CHOICE

1. When a researcher writes a proposal for studying the amount of fe ar preoperative patients experience, which element of the proposal justifies conducting the study in the first place?

a. Identification of a research gap b. Choice of a framework c. Selection of an appropriate methodology d. Conduct of a systematic review ANS: A After the review of the literature, the gap in the knowledge base is identified, with a description of how the proposed study is expected to contribute to fill that particular gap. Your proposal

should identify the target population to which your study findings will be generalized and the accessible population fr om which the sample will be selected. Outline the inclusion and exclusion criteria you will use to select a study participant or subject, and pre sent the rationale for these sample criteria. For example, a participant might be selected according to the following sam ple criteria: female age 18 to 60 years, hospitalized, and 1 day postabdominal surgery. The rationale for the se criteria might be that the rese archer wants t o examine the effects of a selected pain management intervention on adult fem ales who have recently experienced hospitalization and abdominal surgery. The sam pling method and the approximate sam ple size are discussed in terms of their adequacy and limitations in investigating the research purpose (Thom pson, 2002). Usually, a power analysis is conducted to determine an adequate sample size to identify significant relationships and differences in studies.

DIF: Cognitive Level: Application REF: MCS: 639

2. Why do student research proposals usually require greater detail than those developed for review by funding organizations?

a. Student research proposals have a minimum MCS: limit, because faculty want their students to experience the worst-case scenario while in school, where support is readily available.

b. Institutional review boards are very apprehensive about students performing research, and for this reason they require more detailed justification than do other proposals.

c. Students do not write well, so their proposals tend to be more involved. d. The student s proposal often contains the first three or four chapters of the stude nts thesis or dissertation; funding pr oposals usually cont ain a much le ss det ailed literature review.

ANS: D The content of a student proposal usually requires greater detail than does a proposal developed for an agency or funding organization. The proposal is often the first three or four chapters of the students thesis or dissertation, and the proposed study is discussed in the future tensethat is, what the student will do in conducting the rese arch. A stude nt research pr oposal usually include s a title MCS: with the title of the proposal, the name and credentials of the investigator, the university name, and the date.

DIF: Cognitive Level: Analysis REF: MCS: 636 MULTIPLE RESPONSE

1. A form al, detailed rese arch pr oposal is written. Which of the following would be re asons that a rese archer would write a detailed research proposal? (Select all that apply.)

a. It is submitted be fore a nurse m anager performs a quality im provement review of compliance with a new IV start protocol.

b. It is required by a thesis or dissertation committee. c. It is submitted to gain institutional review board approval. d. It is to be submitted for a funding grant. e. It is written to obtain support from one s peers for a study conducted in a hospital medicalsurgical unit.

ANS: B, C, D Researchers need to develop a quality study proposal to facilitate university and clinical agency institutional review boar d approval, obt ain funding, and successfully conduct the study. In addition, student rese archers develop proposals to communicate their research projects to the faculty and members of univer sity and agency institutional review boards. Student pr oposals are written to satisfy requirements for a degree and are usually developed according t o guideline s outlined by the faculty. The content of a student proposal usually requires greater detail than does a proposal developed for an agency or funding organization.

DIF: Cognitive Level: Application REF: MCS: 635

2. What is the difference between a quantitative research proposal and a quantitative research report?

(Select all that apply.)

a. The proposal precedes the study and is written to obtain permission or clearance for the research to be funded, take place, be approved at the research site, and so forth.

b. They are identical. c. The research proposal does not contain results or a discussion section.

d. The research report follows the study and include s both result s of the study and a full discussion.

e. The research report contains a framework, but the proposal does not.

ANS: A, C, D A research proposal is a written plan that identifies the major elements of a study, such as the rese arch problem, purpose, and framework, and outline s the methods and procedures t o conduct the proposed study.

A proposal is a formal way to communicate ideas about a study to see k approval to conduct the study and obtain funding. Researcher s, seeking approval to conduct a study, submit the proposal to a select group for review and, in many situations, verbally de fend the proposal. Receiving approval to conduct research has become more complicated because of the increasing complexity of nur sing studie s, the difficulty involved in recruiting study participant s, and rising concerns over legal and ethical issues. The research report include s four m ajor sections or content are as: (1) introduction, (2) methods, (3) results, and (4) discussion of the findings. The introduction customarily contains both the literature review and the study framework.

DIF: Cognitive Level: Synthesis REF: MCS: 635

3. Which of the following elements do a research proposal and a research report have in common?

(Select all that apply.)

a. Discussion b. Review of the literature c. Results d. Framework e. Methods f. Research problem g. Research purpose h. Introduction ANS: B , D, E, F, G, H

A research proposal is a written plan that identifies the major elements of a study, such as the rese arch problem, purpose, and framework, and outline s the methods and procedures t o conduct the proposed study.

A proposal is a formal way to communicate ideas about a study to see k approval to conduct the study and obtain funding. Researcher s, seeking approval to conduct a study, submit the proposal to a select group for review and, in many situations, verbally de fend the proposal. Receiving approval to conduct research has become more complicated because of the increasing complexity of nur sing studie s, the difficulty involved in recruiting study participant s, and rising concerns over legal and ethical issues. The research report include s four m ajor sections or content are as: (1) introduction, (2) methods, (3) results, and (4) discussion of the findings. The introduction customarily contains both the literature review and the study framework.

DIF: Cognitive Level: Analysis REF: MCS: 635

4. A researcher writes a preproposal. What exactly is a preproposal? (Select all that apply.) a. A justification for a research study b. A request for institutional review board approval c. A brief overview of a proposed project d. A first draft of a proposal e. A short document exploring funding opportunities for a research study ANS: C, E Sometimes a re searcher will send a preproposal or query letter rather than a proposal to a funding institution.

A preproposal is a short document of four to five MCS: plus appendice s that explores the funding possibilities for a research project. The parts of the preproposal are logically ordered as follows: (1) letter of transmittal, (2) proposal for research, (3) personnel, (4) facilities, and (5) budget. The proposal pr ovide s a brief overview of the proposed pr oject, including the rese arch problem , purpose, methodology (brief de scription), and, m ost important, a statement of the significance of the work to knowledge in general and the funding institution in particular. By de veloping a preproposal, researchers are able to determine the agencies interested in funding their study and limit submission of their proposals to only institutions that indicate an interest.

DIF: Cognitive Level: Comprehension REF: MCS: 636

5. When conducting a review of a proposal, which of the following que stions would be concerns of an institutional review board (IRB)? (Select all that apply.)

a. Is this study congruent with our hospitals research agenda? b. What will be the impact of this study on our hospital and its clients? c. Is this proposal literate and well written? d. Does this study have any scientific merit? e. What prior research experience does this author have? f. Will the human subjects studied be protected from harm? g. What is the quality of this study?

ANS: A, B, D, F, G Clinical agencies and health care corporations review studies for the following reasons: (1) to evaluate the quality of the study, (2) to ensure that adequate measures are being taken t o protect hum an subjects, and (3) to evaluate the impact of the study on the reviewing institution. Most agency IRBs screen pr oposals for (1) scientific merit, (2) protection of human right s, (3) congruence of the study with the agencys rese arch agenda, and (4) impact of the study on patient care.

DIF: Cognitive Level: Comprehension REF: MCS: 645

6. Why does a qualitative rese arch proposal contain both the research philosophy and general method and the applied method of inquiry? What is the distinction between these? (Select all thatapply.)

a. The research philosophy and general method are the name of the method phenomenology, grounded theory, and so forth.

b. The general method is the way the researcher plans to collect the data. c. The applied method of enquiry is the way the researcher plans to collect the data. d. The applied method refers t o whether the study is phenomenology, gr ounded theory, ethnography, and so forth.

e. They are both the same.

ANS: A, B Qualitative rese arch proposal guidelines are unique for the development of knowledge and the ories using a variety of qualitative rese arch methods. A qualitative pr oposal usually include s the following content areas: (1) introduction, (2) research philosophy and general method, (3) applied method of inquiry, and (4) current knowle dge, limitations, and plans for communication of the study findings. The research philosophy and general method section introduces the reader to the philosophical and conceptual foundation for the qualitative research method (phenomenological rese arch, ethnographic research, grounded theory research, exploratory- descriptive qualitative research, or historical research) selected for the proposed study.

Identifying the methods for conducting a qu alitative study is a difficult task because sometimes the specifics of the study de sign emerge during the study. Unlike quantitative re search, in which the de sign is a fixed blueprint for a study, the de sign in qualit ative research emerges or evolves as the study is conducted. Thus, you must document the logic and appropriateness of the qualitative method and develop a tentative plan for conducting your study. Because this plan is tentative , reserve the right to modify or change the plan as neede d during the conduct of the study. Howe ver, the de sign or plan must (1) be consistent with the philosophical appr oach, study pur pose, and specific research aim s or questions, (2) be well conceived, and (3) address prior criticism, as appropriate.

DIF: Cognitive Level: Analysis REF: MCS: 640

7. Why should a qualit ative research proposal intended for institutional board review address methods, since methods can be flexible in qualitative research? (Select all that apply.)

a. The committee must be aware of anything that will be done to the participants, including interviewing.

b. The committee must adjudge potential harm that emanates from discussion of disturbing topics.

c. The committee must be apprised of planne d methods at the beginning of the study; researchers must ask for permission if they decide to add anything to the methods while the study is in progress.

d. The forms for institutional review include this section, but it isnt really addressed in qualitative research, since there is no intervention, per se.

e. The committee must determine the relative risk of accidental disclosure of potentially embarrassing information.

ANS: A, B, C, E The sensitive nature of some qualit ative studies increases the risk for participants, which make s ethical concerns and decisions a m ajor focus of the study. The institutional review board must know how the researcher will minimize harm to research subjects.

DIF: Cognitive Level: Synthesis REF: MCS: 640

8. Why might proposal revisions be required? (Select all that apply.) a. The review process may reveal unreasonable impact on one area of the institution, since other research is in progress; a change of venue could be indicated.

b. Funding becomes unavailable and the proposal must be revised, in accordance with cuts. c. Several potential subjects refuse to participate in the research study. d. The study methodology is we ak, and the reviewers suggestions will impr ove the strength of the methodology.

e. The researcher has inadvertently submitted materials that contain errors.

ANS: A, B, D, E Reviewers sometimes sugge st changes in a proposal that improve the study methodology; however, some of the changes requested may bene fit the institution but not the study. Remain receptive to the suggestions, explore with the committee the impact of the change s on the proposed study, and try to resolve any conflicts.

Usually reviewers make valuable sugge stions that might im prove the quality of a study or facilit ate the dat a collection process. Revision of the proposal is often based on these sugge stions before the study is implemented. Sometimes a study requires revision while it is being conducted because of problems with dat a collection tools or subjects participation. Howe ver, if clinical agency per sonnel or representative s of funding institutions have approved a proposal, the researcher needs to examine the situation seriously

before making major changes in the study. Before revising a proposal, address three questions: (1) What needs to be changed? (2) Why is the change necessary? (3) How will the change affect implementation of the study and the study findings?

Chapter 29. Seeking Funding for Research MULTIPLE CHOICE

1. What do the Association of Womens Health, Obstetric, and Neonat al Nurses, National Gerontological Nur sing Association, and Emergency Nurses Association have in common, relative to funded research?

a. All three were established based on funded research. b. All provide proofreaders, free of charge, who will assist with grant writing. c. All three fund research. d. All three provide research guidance and funding through Sigma Theta Tau. ANS: C Many of the specialty practice nursing organizations provide support for studie s relevant to their specialty, including nurse pr actitioner groups. These organizations often provide guidance to budding new rese archers who need assistance in beginning the process of planning and seeking funding for research. To determine the resources provide d by a particular nursing organization, search their website or cont act the organization by e mail, letter, or phone. Three of these are the Association of Womens Health, Obstetric, and Neonat al Nurses; National Gerontological Nursing Association; and Emergency Nurses Association.

DIF: Cognitive Level: Analysis REF: MCS: 668

2. A researcher receives a rejection letter concerning a proposal submitted for major funding. What should now be done?

a. The researcher should not apply for another grant for at least a year. b. The comments in the letter should be reviewed, so as to rewrite the proposal for the next review cycle.

c. A formal protest should be filed. d. The contact person for the grant should be reached by e-mail as soon as possible.

ANS: B The researchers reaction to a rejected proposal is usually anger and then depression. The frustrated researcher may abandon the proposal, stuff it in a bottom drawer somewhere, and forget it. There seems to be no way to avoid the anger and depression after a rejection because of the significant emotion and time invested in writing the proposal. However, after a few weeks it is advisable to examine the rejection letter again. The comments can be useful in rewriting the proposal for resubmission. The learning experience of rewriting the proposal and evaluating the comment s will provide a background for seeking funding for another study.

A skilled grant writer will have approxim ately one proposal funded for every five submitted. The average is far less than this.

DIF: Cognitive Level: Comprehension REF: MCS: 671

3. What is the percentage rejection rate for new grant writers? a. Less than 20% b. Approximately 50% c. 80% d. Greater than 80% ANS: D A skilled grant writer will have approxim ately one proposal funded for every five submitted. The average is far less than this.

DIF: Cognitive Level: Analysis REF: MCS: 671 MULTIPLE RESPONSE

1. Why is seeking research funding important? (Select all that apply.)

a. Funding implies both scientific and social merit. b. Funding allows the re searcher to hire assistant s who attend to the tasks of research, leaving the researcher free for design of more and better projects.

c. The academic reputation of the researcher increases as grant funding increases. d. Research cannot be conducted unless formal funding is obtained. e. Well-designed studies can be expensive, especially those with complex designs. f. A funded study is much more likely to be published.

ANS: A, B, C, E Seeking funding for research is important, both for the rese archer and for the profe ssion. Well - de signed studies can be expensive. As the rigor and com plexity of the study design increase, the cost tends to incre ase.

By obt aining funding, the researcher can conduct a complex, well- designe d study. Funding indicate s that others have reviewed the study and recognize its scientific and social merit. In fact, the scientific credibility of the profession is related to the quality of studie s conducted by it s researchers. Thus, scientific credibility and funding for research are interrelated. The profession of nursing has invested a great deal of energy in increasing the sources of funding and am ount of money available for nursing research. Each award of funding enhance s the status of the researcher and increases the possibilities of greater funding for later studies. In addition, funding provides practical advantages. For example, funding may reimburse part or all of the researchers salary and release the researcher from other responsibilities, allowing the researcher to devote time to conducting the study. Funding provides the rese archer with the resources to hire research assist ants and study coordinators to facilitate data collection and enhance your productivity.

DIF: Cognitive Level: Analysis REF: MCS: 663

2. What are the advantages of a research apprenticeship? (Select all that apply.) a. Entry into a functional research team b. Extremely good wages c. Experience gained in grant writing d. A chance to read proposals that have been funded

e. The opportunity to learn research and grantsmanship f. A chance to read proposals that have not been funded g. A guaranteed job after the apprenticeship ends ANS: A, C, D, E, F Volunteering to assist with the activities of another researcher is an excellent way to learn research and grantsm anship. Graduate students can gain this experience by becoming gr aduate research assistant s.

Through an apprenticeship, one m ay gain experience in writing grants and reading proposals that have been funded. Examining proposals that have been rejected can be useful if the comments of the review committee are available. The criticisms of the review committee point out the weaknesse s of the study and clarify the reasons why the proposal was rejected. Examining these comments on the proposal can increase one s insight as a new gr ant writer and prepare a novice for similar experiences. However, some rese archers are sensitive about these criticisms and m ay be reluct ant to share them. If an experienced rese archer is willing, it is enlightening to hear his or her perceptions and opinions about the criticisms. Ideally, by wor king closely with an experienced researcher, one has the opportunity to demonstrate one s commitment and the researcher may ultimately invite the novice to become a permanent member of a research team.

DIF: Cognitive Level: Synthesis REF: MCS: 666

3. Why is serving on a research committee or institutional review board useful for the person interested in gaining research funding? (Select all that apply.)

a. People who serve on research committees are given priority funding approval. b. Seeing the mistakes others make creates an awareness of common errors. c. Contacts with researchers can be made. d. When ones own proposals are reviewed, the committee will feel more inclined t o approve them.

e. Reading a clear, organized proposal provides a template.

ANS: B, C, E

Research committees and institutional review boards exist in many health care and professional organizations.

Through membership on these committees, contact s with researchers can be m ade. Also, many research committees are involved in reviewing proposals for the funding of sm all grants or granting appr oval to collect data in an institution. Often reading proposals for approval for human subjects research or for funding can give the novice researcher insight into the importance of clarity and organization in the research pr oposal.

Reviewing proposals and making decisions about funding help researchers become better able to critique and revise their own proposals before submitting them for review.

DIF: Cognitive Level: Synthesis REF: MCS: 667

4. What is the difference between a nur sing project grant pr oposal and a nursing research grant? (Select all that apply.)

a. A research grant is awarded for a promising planned study. b. Research grants and project grants are identical. c. A project grants program can be academic or clinical. d. A research grant is awarded for outstanding past research. e. A project grant is awarded to support a novel program.

ANS: A, C, E Two main type s of grant s are sought in nursing: project grant s and research gr ants. Project grant pr oposals are written to obtain funding for the development of new educational program s in nursing, such as a program designed to teach nurse s to provide a new type of nur sing care or a pr oject to support nursing students seeking advanced degrees. These grant s may fund a project manager to achieve the goals of the grant.

Although the se progr ams may involve evaluation, they seldom involve research. For example , the effectivene ss of a new approach to patient care may be evaluated, but the findings can seldom be generalize d beyond the unit or institution in which the patient care was provided. The emphasis is on implementing t he project, not on conducting research. Research grant s provide funding to conduct a study. Although the two types of grant proposals have similarities, they have important differences in writing techniques and flow of ide as, as well as content.

DIF: Cognitive Level: Synthesis REF: MCS: 667

5. Many hospitals and universities have access to both SPIN and The Foundation Directory. Why are these useful for a researcher? (Select all that apply.)

a. They provide leads for thousands of grant opportunities. b. They provide information only for small grants of less than $5,000 each. c. They provide information on fe deral agencie s, private foundations, and corporate foundations.

d. They are computerized information resources. e. They provide funding information; all fees are then used to support future grants.

ANS: A, C, D A computerized information system, the Sponsored Program s Information Network (SPIN), can assist researchers in locating the most appropriate funding sources t o support their research interests. The database contains approximately 2,000 progr ams that provide inform ation on federal agencies, private foundations, and corporate foundations. Many universities and research institutions have acce ss to SPIN. Other databases include private funding as well.

DIF: Cognitive Level: Analysis REF: MCS: 669

6. A new researcher obt ains a large grant and proceeds to hire nine assistant s, as the grant specifie s. The new researcher hires a statistician, three persons to collect dat a, one person to schedule and coordinate the activities of the persons collecting data, one person to help with qualit ative data analysis, one person to begin writing for the grant renewal, one person to write the interim report, and one person to manage the grant budget, writing weekly checks to the research assist ants based on their submitted timecards. Which of these activities is appropriate for a hired assistant? (Select all that apply.)

a. Advising the research team about appropriate statistical tests b. Recalculating the study power after data collection on the first thirty subjects, to be sure of the effect size

c. Performing initial qualitative coding of raw data

d. Writing the first draft of a renewal grant e. Writing the interim report for the institutional review board f. Managing the grant budget g. Writing weekly checks to the research assistants ANS: A, B, C, G Although the supporting institution is ultimately responsible for dispensing and controlling grant monies, the primary investigator (PI) is responsible for keeping track of budget expenditures and m aking decisions about how the m oney is to be spent. If funding is through a federal agency, t he PI will be required t o provide interim reports as well as updates on the progress of the study. The PI interviews, hires, trains, and oversee s grant personnel. During a large study with several inve stigator s and other grant per sonnel, the PI coordinate s activities, often through formal meetings of all grant workers at intervals to share ide as and solve problems.

Federal grant s require the PI to submit interim reports according to preset deadlines. The PI often writes the renewal grant as soon as the first grant has been made, so that continuous re search activity can be accomplished. In theory, the PI could be planning one study, collecting dat a on a second study, analyzing dat a on a third study, and writing papers for publication on a fourth study. A full -time researcher could have completed one funded study, be in the last year of funding for a second study, be in the first year of funding for a third study, and be seeking funding for a fourth study.

DIF: Cognitive Level: Application REF: MCS: 671

7. What are two national nursing organizations that provide small grant s not linked t o a nursing specialty area? (Select the two that apply.)

a. The Society for Pediatric Nurses b. American Nurses Foundation c. The Board of Registered Nursing d. The American Cancer Society e. Sigma Theta Tau, International f. The National Association of Hospitals and Clinics

ANS: B, E Two national nur sing organizations that provide sm all grants not linked to a specialty are the American Nurses Foundation and Sigm a Theta T au, International. These grant s are usually for le ss than $7,500 e ach year, are very com petitive, and are awarded to new investigators with promising ideas. Receiving funding from these organizations is held in high regard.